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Simultaneous Idiopathic Dissections of the Coronary and Superior Mesenteric Arteries

Masato Nishi1, Daisuke Sueta1, Takashi Miyazaki1

  • 1Department of Cardiovascular Medicine, Kumamoto University Graduate School of Medical Sciences, Japan.

Internal Medicine (Tokyo, Japan)
|June 2, 2017
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) and superior mesenteric artery dissection (SMAD) may share similar underlying causes. This case highlights a potential link between these serious vascular conditions.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction, particularly in younger women, but can occur in men.
  • Superior mesenteric artery dissection (SMAD) is a critical condition often associated with atherosclerosis and connective tissue disorders.

Observation:

  • A 49-year-old male presented with acute upper abdominal pain, initially undiagnosed.
  • Following discharge, he developed left chest pain, diagnosed as acute myocardial infarction.
  • Coronary angiography revealed severe left coronary artery stenosis, and intravascular ultrasound identified spontaneous coronary artery dissection (SCAD).

Findings:

  • The SCAD lesion was successfully treated with stenting.
  • Subsequent atherosclerosis screening revealed a concurrent superior mesenteric artery dissection (SMAD).
  • The SMAD lesion was also successfully treated with stenting.

Implications:

  • This case suggests a potential common pathological background for SCAD and SMAD.
  • Further research into shared risk factors and pathophysiology for these arterial dissections is warranted.
  • Highlights the importance of considering systemic vascular abnormalities in patients presenting with arterial dissection.

Keywords:
spontaneous coronary artery dissectionsuperior mesenteric artery dissection

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