Spontaneous coronary artery dissection by intravascular ultrasound in a patient with myocardial infarction
Ji Hun Jang1, Dae Hyeok Kim1, Dong Hyuk Yang1
1Division of Cardiology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
Insights
Spontaneous coronary artery dissection (SCAD) is a rare cause of heart attack, particularly in younger individuals. This report details two middle-aged men treated for SCAD-induced myocardial infarction using percutaneous coronary angioplasty.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) and sudden cardiac death.
- SCAD diagnosis and management remain challenging due to unclear incidence, causes, and pathogenesis.
- Consideration of SCAD is crucial in young patients without traditional cardiovascular risk factors and in peripartum women presenting with ACS.
Observation:
- This report presents two cases of middle-aged males experiencing myocardial infarction.
- Both patients presented with symptoms indicative of acute coronary syndrome.
Findings:
- The two male patients diagnosed with spontaneous coronary artery dissection underwent percutaneous coronary angioplasty.
- Percutaneous coronary angioplasty was a viable treatment option for these specific SCAD cases.
Implications:
- These cases highlight the importance of considering SCAD in middle-aged men presenting with myocardial infarction.
- Percutaneous coronary intervention can be an effective treatment strategy for SCAD in select patient populations.
- Further research is needed to clarify the optimal treatment pathways for spontaneous coronary artery dissection.
Abstract:
Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome and sudden cardiac death. The incidence, causes, pathogenesis, and treatment have not been defined clearly, but spontaneous coronary artery dissection should be considered in young patients without major cardiovascular risk factors or in patients in the peripartum period who present with acute coronary syndrome. The treatment is often challenging. Medical treatment is usually considered, and percutaneous coronary intervention or coronary artery bypass surgery may be possible in some patients. We herein report two cases of middle-aged males with myocardial infarction who were treated with percutaneous coronary angioplasty.
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