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Simultaneous spontaneous arterial dissections in a 38-year-old woman presenting during the covid-19 pandemic: a case

Lynsey Hewitson1, Chih Wong1, Shahid Aziz1

  • 1Cardiology Department, Southmead Hospital, Bristol, BS10 5NB, UK.

European Heart Journal. Case Reports
|March 18, 2021
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) can occur with vertebral artery dissection, even without pregnancy. Early diagnosis and recognition of underlying arteriopathy are crucial for managing these rare, simultaneous events.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is a key cause of heart attacks in young women.
  • Fibromuscular dysplasia is a common arteriopathy associated with SCAD.
  • SCAD often presents in patients with few traditional cardiovascular risk factors.

Observation:

  • A 38-year-old woman presented with chest pain and elevated cardiac biomarkers.
  • Coronary angiography revealed SCAD of the left anterior descending artery.
  • The patient subsequently developed a severe headache, with imaging confirming a left vertebral artery dissection.

Findings:

  • This is the first reported case of simultaneous spontaneous coronary and vertebral artery dissections unrelated to pregnancy.
  • The patient was managed conservatively with optimal medical therapy.
  • The patient was discharged on Day 7 with a favorable outcome.

Implications:

  • Highlights the importance of diagnosing SCAD and considering concurrent arterial dissections.
  • Emphasizes the need to investigate for underlying arteriopathy in patients with SCAD.
  • Crucial for appropriate patient assessment, follow-up, and management of unexplained symptoms in this population.
Abstract

Keywords:
Acute coronary syndromeCase reportCoronary angiographyFibromuscular dysplasiaSpontaneous coronary artery dissectionVertebral artery dissection

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