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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous

Zoran Jović, Slobodan Obradović, Nemanja Djenić

    Vojnosanitetski Pregled
    |August 1, 2015
    PubMed

    Insights

    Spontaneous coronary artery dissection (SCAD) can cause myocardial infarction in young women. Thrombolytic therapy may be a viable treatment option, leading to good clinical outcomes in some cases.

    Area of Science:

    • Cardiology
    • Vascular Medicine

    Background:

    • Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction, predominantly affecting young women without traditional cardiovascular risk factors or during the peripartum period.
    • SCAD management is challenging due to a lack of established guidelines and often carries a poor prognosis.

    Observation:

    • A case of acute myocardial infarction in a young woman was attributed to spontaneous dissection of the left anterior descending coronary artery.
    • Initial treatment involved thrombolytic therapy followed by conservative management, with coronary angiography revealing a normal artery two years later.

    Findings:

    • Analysis of 19 published cases treated with thrombolysis for SCAD indicated a low complication rate, with only one reported adverse event.
    • The presented case and eight others suggest that thrombolysis can lead to favorable clinical outcomes in SCAD patients.

    Implications:

    • Clinicians should consider SCAD in young women presenting with myocardial infarction, particularly those with no cardiovascular risk factors or in the peripartum phase.
    • While thrombolytic therapy shows promise, further data is needed to confirm its safety and efficacy as a standard treatment for SCAD.
    Abstract

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