Spontaneous Coronary Artery Dissection Accompanied with Antiphospholipid Syndrome and Leukemia

Area of Science:

• Cardiology
• Hematology
• Rheumatology

Background:

• Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial infarction (AMI), particularly in young individuals without traditional cardiovascular risk factors.
• Antiphospholipid syndrome (APS) is typically associated with arterial and venous thromboembolism, but its direct link to SCAD is rare.
• Leukemia, a malignancy of blood-forming tissues, can present with diverse clinical manifestations, including cardiovascular complications.

Observation:

• A young patient presented with AMI, later diagnosed as SCAD, with a history of 6 pack-years of smoking but no other coronary artery disease risk factors or family history.
• Further investigation revealed the co-occurrence of antiphospholipid syndrome (APS) and leukemia in this SCAD patient.
• The patient's SCAD was successfully managed using drug-eluted stents (DES) implantation.

Findings:

• This case suggests that SCAD can be an unusual clinical presentation of APS.
• The successful use of DES implantation demonstrates a viable therapeutic option for SCAD in complex cases.
• The combination of SCAD, APS, and leukemia presents a unique clinical challenge requiring a multidisciplinary approach.

Implications:

• Physicians should consider SCAD as a rare manifestation of APS, even in the absence of typical risk factors.
• Early diagnosis and appropriate management, including advanced stenting techniques, are crucial for favorable outcomes in SCAD patients with underlying systemic conditions.
• This case underscores the importance of comprehensive screening for autoimmune diseases like APS in young patients with unexplained SCAD.