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[Spontaneous coronary artery dissection: Report of two cases]
Revista Medica De Chile
|April 20, 2016
Summary
Spontaneous coronary artery dissection (SCAD) is a rare cause of heart attack, more common in women. This report details two SCAD cases requiring surgical revascularization due to disease progression.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome.
- SCAD is more prevalent in women and linked to peripartum status and oral contraceptive use.
Observation:
- Two cases of SCAD are presented in women presenting with angina.
- One patient had hepatitis C; the other was 32 years old.
- Imaging revealed dissection of major coronary arteries, including left anterior descending and circumflex arteries.
Findings:
- Initial medical management with nitroglycerin, anticoagulation, and anti-platelet drugs was insufficient for symptom relief in one case.
- Surgical revascularization became necessary for both patients due to persistent symptoms and disease progression.
- Retrograde progression of dissection was observed via intravascular ultrasound in one case.
Implications:
- SCAD can present with severe symptoms requiring aggressive management.
- Surgical revascularization may be indicated in complex or progressing SCAD cases.
- Further research into SCAD pathophysiology and optimal treatment strategies is warranted.
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