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Unusual presentation of extensive spontaneous coronary dissection: Case report and literature review

Júlio César Queiroz França1, Márcio Antonio Santos2, Moacir Fernandes Godoy3

  • 1Resident Physician, Department of Cardiology, Hospital de Base, Faculty of Medicine of São José do Rio Preto (FAMERP), São Paulo, Brazil.

ARYA Atherosclerosis
|August 2, 2017
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) can occur in older adults without typical risk factors. This case highlights SCAD in a 63-year-old male, emphasizing the need for diagnostic suspicion.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Spontaneous coronary artery dissection (SCAD) etiology is poorly understood.
  • SCAD is linked to pregnancy, stress, collagen diseases, and vasculitis.
  • Patients often lack traditional coronary artery disease risk factors, necessitating high suspicion in acute coronary syndrome cases, particularly in young adults.

Observation:

  • A 63-year-old asymptomatic male presented for routine evaluation.
  • Exercise and myocardial scintigraphy raised suspicion for severe coronary artery disease.
  • Coronary angiography revealed spontaneous dissection of both left and right coronary arteries.

Findings:

  • The case demonstrates SCAD in an older male patient.
  • Diagnostic evaluation included exercise testing, scintigraphy, and coronary angiography.
  • Angiography confirmed spontaneous dissection in major coronary arteries.

Implications:

  • SCAD diagnosis requires consideration beyond typical risk factors.
  • Therapeutic strategies for SCAD (medical, percutaneous, surgical) require individualized approaches.
  • Further research is needed to understand SCAD in diverse patient populations.
Abstract

Keywords:
Computed Tomography Angiography (CTA)CoronaryCoronary AngiographyDissection

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