Not Your Common Athletic Heart Problem: Using Coronary CTA to Visualize Spontaneous Coronary Artery Dissection

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Sports Cardiology

Background:

• Spontaneous coronary artery dissection (SCAD) is an uncommon cause of myocardial infarction, particularly in young, healthy individuals.
• Athletes may present with anginal symptoms mimicking typical exertional angina, complicating diagnosis.

Observation:

• A 19-year-old collegiate athlete experienced anginal symptoms post-exercise, with elevated troponin and CK-MB levels.
• ECG revealed diffuse biphasic T-waves; coronary CT angiography showed left anterior descending artery dissection and left ventricular apical thrombus.

Findings:

• Coronary catheterization confirmed left anterior descending artery dissection.
• The case highlights SCAD as a differential diagnosis in young athletes with non-ST-elevation myocardial infarction (NSTEMI).

Implications:

• Prompt diagnosis of SCAD is essential, even in the absence of traditional risk factors.
• Awareness of potential complications, such as intracardiac thrombi, is critical for guiding therapeutic strategies and improving patient outcomes.