[Spontaneous coronary artery dissection and ST-segment elevation myocardial infarction (STEMI)]
G Malcles1, N Combaret1, P Motreff1
1Department of Cardiology, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
Insights
Spontaneous coronary artery dissection (SCAD) is a heart condition affecting young women. Optical coherence tomography aids in diagnosing SCAD, even without intimal rupture, improving patient management.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of acute coronary syndrome, primarily affecting young women.
- Diagnosis via coronary angiography can be challenging, especially for intramural hematomas without intimal rupture.
Observation:
- A 49-year-old woman presented with STEMI attributed to an intramural hematoma.
Findings:
- Intracoronary imaging, particularly optical coherence tomography (OCT), offers significant advantages for SCAD diagnosis and management.
- OCT can identify intramural hematomas not evident on conventional angiography.
Implications:
- Improved diagnostic accuracy for SCAD using OCT can lead to timely and appropriate treatment.
- Further research into SCAD epidemiology, pathophysiology, and long-term outcomes is warranted.
Abstract:
Spontaneous coronary artery dissection (SCAD) is a poorly understood and under-diagnosed entity of acute coronary syndrome, affecting predominantly young women. On coronary angiography, the diagnosis remains challenging, particularly in case of intramural hematoma without intimal rupture. Intracoronary imaging, especially by optical coherence tomography (OCT), provides an incremental value in terms of diagnosis and management. We report the case of a 49-year-old woman admitted for STEMI caused by an intramural hematoma. In the discussion part, we aim to review the epidemiology, physiopathology, diagnosis, management and long-term prognosis of SCAD.
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Coronary Artery Disease II: Pathophysiology
01:30Coronary Artery Disease III: Clinical Manifestations
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...