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Spontaneous Coronary Artery Dissection in a Liver Transplantation Candidate
Zachary Oman1, Nauman Khalid1, Ihab Hassanieh1
1Zachary Oman, Do, MBA and Ihab Hassanieh, MD, are in the Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri. Nauman Khalid, MD, is at the MedStar Washington Hospital Center, Washington, DC. Michael Lim, MD and Tarek Helmy, MD, are at the Center for Comprehensive Cardiovascular Care, Department of Cardiovascular Medicine, Saint Louis University School of Medicine, St. Louis, Missouri.
Insights
Spontaneous coronary artery dissection (SCAD) is a rare heart condition affecting women. This case highlights SCAD in a woman with ulcerative colitis and cirrhosis undergoing liver transplant evaluation.
Area of Science:
- Cardiology
- Gastroenterology
- Hepatology
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome, primarily affecting women.
- Known risk factors include stress, female gender, pregnancy, fibromuscular dysplasia, and inflammatory disorders.
Observation:
- A middle-aged female patient with ulcerative colitis and cirrhosis due to primary sclerosing cholangitis was evaluated for liver transplantation.
- Cardiac evaluation revealed spontaneous coronary artery dissection.
Findings:
- The case presents a unique association between SCAD and inflammatory conditions like ulcerative colitis and primary sclerosing cholangitis.
- SCAD was identified during the workup for liver transplantation.
Implications:
- This case expands the understanding of potential risk factors and associations for SCAD.
- Highlights the importance of cardiac evaluation in patients with complex inflammatory and liver diseases.
Abstract:
Spontaneous coronary artery dissection (SCAD) is an uncommon and potentially fatal cause of acute coronary syndrome, myocardial infarction, and sudden death primarily affecting women. While the exact cause of SCAD is unknown, associated risk factors are emotional or physical stress, female gender, pregnancy-related factors including hormonal changes, fibromuscular dysplasia, mixed connective tissue disorders, and inflammatory disorders. In this report, we present a middle-aged female with ulcerative colitis and cirrhosis secondary to primary sclerosing cholangitis who was found to have SCAD on cardiac evaluation for liver transplantation workup.
