Related Experiment Video
Updated: Apr 29, 2026
06:18
An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
Published on: August 13, 2019
11.7K
Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy
Alexander L Pan1, David Fergusson1, Robert Hong1
1Division of Cardiology, The John A. Burns School of Medicine, University of Hawaii, Queens Medical Center, Honolulu, HI 96813, USA.
Case Reports in Cardiology
|May 15, 2014
Summary
Spontaneous coronary artery dissection (SCAD) is rare but can occur with hormonal therapies. This case report highlights a potential link between topical hormone replacement therapy and SCAD, suggesting a need for awareness.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome.
- SCAD is often associated with conditions of high systemic estrogen, such as pregnancy and oral contraceptive use.
- Topical hormone replacement therapy (HRT) can increase estrogen levels, but its link to SCAD is not previously reported.
Purpose of the Study:
- To report a case of SCAD in a patient using topical HRT.
- To investigate the potential role of topical HRT in the development of SCAD.
Main Methods:
- Case report of a 53-year-old female patient.
- Detailed medical history review, focusing on HRT use and cardiac events.
- One-year follow-up after cessation of topical HRT.
Main Results:
- The patient experienced two SCAD events while using topical HRT.
- No other risk factors for coronary dissection were identified.
- The patient remained event-free for one year after discontinuing topical HRT.
Conclusions:
- Topical HRT may be a potential contributing factor to SCAD.
- Clinicians should consider topical HRT in the differential diagnosis of SCAD, especially in women without other risk factors.
- Further research is warranted to explore the association between topical HRT and SCAD.
Related Concept Videos
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
943
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
943
01:26Coronary Artery Disease II: Pathophysiology
1.1K
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
1.1K
01:19Regulation of Hormone Secretion
6.5K
Regulation of hormone secretion is a finely tuned orchestration driven by various types of stimuli, encompassing neural, humoral, and hormonal signals. Environmental cues instigate neural stimuli, where action potentials traverse nerve fibers to reach their designated targets. An illustrative scenario is the body's response to stress, wherein the sympathetic nervous system releases epinephrine from the adrenal glands, inducing the well-known 'fight or flight' reaction.
Humoral...
Humoral...
6.5K
01:30Acute Coronary Syndrome III: Diagnostic Studies
495
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
495
01:26Acute Coronary Syndrome V: Nursing Management
619
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
619
01:30Acute Coronary Syndrome I: Introduction
2.1K
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
2.1K