[Spontaneous coronary artery dissection: An exceptional cause of acute coronary syndrome]
H Yao1, A Ekou1, J J N'Djessan1
1Institut de cardiologie d'Abidjan, 01 BP V 206, Abidjan, Cote d'Ivoire.
Insights
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome. These cases in older African patients highlight SCAD
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS), typically affecting younger women.
- SCAD can lead to sudden death and is often underdiagnosed.
Observation:
- Two cases of SCAD presenting as ACS in Black African patients aged 56 and 52 years are reported.
- Coronary angiography revealed spontaneous dissection of the right coronary artery in one patient and the distal left anterior descending artery in the other.
- Both patients were managed conservatively with antiplatelet agents, beta-blockers, ACE inhibitors, and statins.
Findings:
- Both patients experienced a favorable in-hospital course following conservative management.
- These cases demonstrate that SCAD can occur in older individuals and different ethnic populations.
- SCAD should be considered in the differential diagnosis of ACS, even in atypical demographics.
Implications:
- Increased awareness and implementation of interventional cardiology in Sub-Saharan Africa are crucial for identifying SCAD.
- Early diagnosis and appropriate management of SCAD can improve patient outcomes.
- Further research is needed to understand the prevalence and risk factors of SCAD in diverse populations.
Abstract:
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) or sudden death, which typically affects young women. We reported two cases of black Africans patients, aged 56 and 52 years old, who presented to Abidjan Heart Institute for ACS. Coronary angiography showed spontaneous dissection of the right coronary artery in the first case, and dissection of the distal left anterior descending artery in the second. A conservative approach was preferred. Both patients received antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors and statins, with a favorable in-hospital course. These cases highlight SCAD as a possible cause of ACS. Implementation of interventional cardiology in Sub-Saharan Africa will help identify this uncommon cause of ACS.
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