Spontaneous coronary artery dissection as a cause of myocardial infarction

Area of Science:

• Cardiology
• Vascular Medicine
• Medical Case Reports

Background:

• Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome, predominantly reported in younger women.
• Typical SCAD presentation involves a single coronary artery, often the left anterior descending artery.

Observation:

• A 70-year-old male presented with acute chest pain and ST-segment depression, indicative of myocardial infarction.
• Coronary angiography revealed simultaneous SCAD in the left anterior descending (LAD) and left circumflex (LCx) arteries.
• The LCx artery SCAD resulted in complete occlusion, while the LAD artery exhibited co-existing SCAD and a muscular bridge at the same location.

Findings:

• This case documents SCAD occurring concurrently in two major coronary arteries in an elderly male patient.
• The simultaneous presence of a muscular bridge and SCAD in the LAD artery represents a unique anatomical concurrence.
• Successful percutaneous coronary intervention with stenting was performed for both affected coronary arteries.

Implications:

• This report expands the known demographic profile of SCAD, including older males.
• The co-occurrence of SCAD with a muscular bridge warrants further investigation into potential pathogenetic links.
• Such complex SCAD presentations necessitate tailored interventional strategies for optimal patient outcomes.