Spontaneous Dissection of the Coronary Vessels. Epidemiological and Coronary Angiographic Study

Spontaneous dissection of the coronary arteries is relatively rare and usually does not affect life expectancy. However specific types have been implicated to episodes of sudden cardiac death and myocardial ischemia. The recognition of both clinical and imaging characteristics contributes to appropriate decision and patient management.

The aim of the study is the epidemiological and Coronary Angiographic (CA) estimation of patients with spontaneous dissection of the coronary arteries, who were hospitalized in the cardiology department with Acute Coronary Syndrome or were submitted to coronary angiographic examination in the laboratory.

The epidemiological, clinical and angiographic data of 31 patients who were hospitalized in our department and suffered from spontaneous dissection of the coronary vessels were studied retrospectively.

In 31 patients (11 men and 20 women, mean age 52.8+18.6 years) who were hospitalized for acute coronary syndrome (ACS), spontaneous dissection of coronary arteries was detected. Precipitating factors were hypertension in 12 patients (38.71%), dyslipidemia in 13 patients (42%) and smoking in 17 patients (54.84%). Among the women, 13 (65%) had a history of hypertension in pregnancy, preeclampsia or/and gestational diabetes. In 8 patients, the coronary angiography showed multivessel disease, while in 12 patients there were no significant lesions in the coronary vessels. Fourteen women (70%) reported a history of depression compared to none in men.

The incidence of spontaneous dissection of the coronary vessels in this sample of patients from northern Greece is similar to that of the other centers. The incidence is greater in females with hormonal changes and depression. In a large number there were no significant atherosclerotic lesions.