Spontaneous coronary artery dissection with left ventricular thrombus
Joseph H Joo1, Angel E Caldera2, Vijay G Divakaran2
1College of Medicine, Texas A&M UniversityRound RockTexas.
Proceedings (Baylor University. Medical Center)
|April 9, 2019
Insights
Spontaneous coronary artery dissection (SCAD) is a rare heart condition. This case study highlights conservative management with medication for SCAD leading to heart attack and blood clot.
Area of Science:
- Cardiology
- Vascular Biology
- Internal Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon, non-atherosclerotic cause of acute coronary syndrome (ACS).
- The precise etiology and optimal therapeutic strategies for SCAD are not well-established.
- SCAD requires careful consideration in patients presenting with ACS, particularly those without traditional cardiovascular risk factors.
Observation:
- A patient with multiple cardiovascular risk factors presented with symptoms of acute myocardial infarction.
- Diagnostic imaging confirmed spontaneous coronary artery dissection leading to anterior wall myocardial infarction.
- A left ventricular thrombus was identified in the affected patient.
Findings:
- The patient diagnosed with SCAD and associated complications was managed conservatively.
- Pharmacological treatment included anticoagulant and antiplatelet therapies.
- This approach aimed to prevent further thrombotic events and allow for potential arterial healing.
Implications:
- Conservative management with medical therapy can be a viable option for select SCAD patients.
- This case underscores the importance of considering SCAD in the differential diagnosis of ACS.
- Further research is needed to define evidence-based treatment guidelines for SCAD and its complications.
Abstract:
Spontaneous coronary artery dissection (SCAD) is a rare, nonatherosclerotic cause of acute coronary syndrome. The etiology is unclear, and optimal treatment for SCAD remains undefined. We describe a patient with significant cardiovascular risk factors who presented with SCAD resulting in anterior wall acute myocardial infarction with left ventricular thrombus. The patient was managed conservatively with anticoagulant and antiplatelet therapy.
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