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Spontaneous coronary artery dissection associated with β-HCG injections and fibromuscular dysplasia

Mathieu Lempereur1, Jasmine Grewal2, Jacqueline Saw1

  • 1Vancouver General Hospital, Vancouver, British Columbia, Canada.

The Canadian Journal of Cardiology
|February 25, 2014
PubMed

Insights

Spontaneous coronary artery dissection (SCAD), a cause of heart attack in young women, may be linked to fibromuscular dysplasia and hormonal factors. This case highlights a potential association with beta-human growth hormone injections.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Biology

Background:

  • Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome, primarily affecting younger women.
  • SCAD is frequently linked to underlying arterial abnormalities and various stressors, including hormonal changes.
  • Previous research established a strong association between fibromuscular dysplasia (FMD) and SCAD, suggesting a causal role.

Observation:

  • This report details the first known case of SCAD occurring in a patient with diagnosed FMD.
  • The SCAD event was observed in conjunction with the administration of beta-human growth hormone (β-hGH) injections.

Findings:

  • The case suggests a potential iatrogenic trigger for SCAD in individuals with pre-existing fibromuscular dysplasia.
  • Hormonal influences, specifically exogenous β-hGH, may precipitate SCAD in susceptible individuals with vascular abnormalities.

Implications:

  • This finding expands the understanding of SCAD's multifactorial etiology.
  • Further investigation is warranted to explore the relationship between exogenous hormone therapy and SCAD in patients with FMD.
  • Clinical awareness of this potential association may inform patient management and risk assessment.

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