[A case of primary coronary artery dissection]

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Primary coronary artery dissection (PCAD) is a rare condition, often spontaneous and not linked to trauma.
• Historically diagnosed primarily at autopsy, advancements in coronary angiography have increased survivor reports.

Observation:

• A 52-year-old man presented with acute inferior myocardial infarction due to spontaneous primary coronary artery dissection.
• Coronary angiography revealed an intimal flap and false lumen in the right coronary artery.
• Follow-up angiography showed stenosis progression without intimal flap, and no coronary spasm was induced.

Findings:

• This represents the 46th reported case of PCAD diagnosed via coronary angiography.
• Right coronary artery dissection is more common in survivors due to the artery's smaller territory.
• While stenosis progressed in this case, natural long-term resolution of dissection is possible.

Implications:

• Increased recognition and improved diagnostic techniques are vital for managing PCAD.
• Understanding the natural history, including potential resolution, is crucial for patient outcomes.
• Further research into PCAD mechanisms and management strategies is warranted.