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Intravascular imaging for cardiac arrest with "normal" coronary arteriography
Tawfiq Choudhury1, Amir Solomonica1, Rodrigo Bagur1
1London Health Sciences Centre, London, Ontario, Canada; Western University, London, Ontario, Canada.
Insights
Spontaneous coronary artery dissection (SCAD) is a rare cause of heart attack. High suspicion and careful intracoronary imaging are key for diagnosing SCAD, especially in complex cardiac arrest cases.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome (ACS).
- A high index of suspicion is crucial for timely diagnosis and management.
Observation:
- This case report details the diagnostic and management challenges of SCAD.
- The patient presented with out-of-hospital cardiac arrest and non-diagnostic initial angiography.
Findings:
- Intracoronary imaging can aid SCAD diagnosis when angiography is inconclusive.
- Careful performance of intracoronary imaging is essential to avoid clinical deterioration.
Implications:
- This case highlights the complexity of SCAD diagnosis and management in critical care settings.
- Enhanced awareness and advanced imaging techniques are vital for improving outcomes in SCAD patients.
Abstract:
Spontaneous coronary artery dissection (SCAD) is an under-recognised presentation of acute coronary syndrome. A high index of suspicion is essential. If diagnostic doubt is high, intracoronary imaging, performed carefully, can be useful, although it can result in worsening of the clinical condition. The current report exemplifies the complexity of diagnosis and management of SCAD in a patient with out-of-hospital cardiac arrest and non-diagnostic angiography.