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Spontaneous Coronary Artery Dissection in Levo-Transposition of the Great Arteries

Avinash V Sharma1, Raja Zaghol1, Ana Barac2

  • 1Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). This case highlights SCAD in a patient with congenital heart disease, emphasizing vigilance in diagnosis.

Area of Science:

  • Cardiology
  • Vascular Biology

Background:

  • Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS).
  • Increasing recognition of SCAD in female patients necessitates heightened clinical awareness.
  • Congenital heart disease (CHD) represents a complex patient population with unique cardiovascular risks.

Observation:

  • A case of SCAD is presented in a patient with pre-existing congenital heart disease.
  • The patient's presentation mimicked typical acute coronary syndrome symptoms.
  • Diagnostic challenges in identifying SCAD, particularly in the context of CHD, were noted.

Findings:

  • SCAD was confirmed as the underlying cause of the acute coronary syndrome.
  • The interplay between congenital heart anomalies and SCAD etiology is explored.
  • This case underscores the importance of considering SCAD in ACS presentations, even with underlying cardiac conditions.

Implications:

  • Clinicians must maintain a high index of suspicion for SCAD in patients presenting with ACS, irrespective of traditional risk factors.
  • Recognition of SCAD in patients with congenital heart disease is crucial for appropriate management and outcomes.
  • Further research into the specific risks and management of SCAD in CHD populations is warranted.

Keywords:
ACS, acute coronary syndromeAMI, acute myocardial infarctionASD, atrial septal defectAo, aortaCC-TGA, congenitally corrected transposition of the great arteriesCMR, cardiac magnetic resonance imagingECG, electrocardiogramL-TGA, levo-transposition of the great arteriesMRI, magnetic resonance imagingPV, pulmonic ventricleRV, right ventricleSCAD, spontaneous coronary artery dissectionSV, systemic ventriclecoronary angiographyspontaneous coronary artery dissectiontransposition of the great arteries

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