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Spontaneous Coronary Artery Dissection and ST-Segment Elevation Myocardial Infarction in an Anomalous LAD Artery

Guson Kang1, Ashish Sarraju1, Takeshi Nishi1

  • 1Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, California.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a growing cause of heart attacks in younger individuals. This case highlights the complex management of SCAD when combined with an unusual coronary artery anomaly.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome (ACS), particularly in younger patients.
  • Management of SCAD is challenging due to the risk of iatrogenic injury during revascularization procedures.

Observation:

  • This report details a case of SCAD with the additional complexity of an anomalous intramural coronary artery.
  • The intramural course of the coronary artery presented unique diagnostic and therapeutic considerations.

Findings:

  • The successful management strategy for this complex SCAD case is discussed.
  • The interplay between SCAD and coronary artery anomalies requires careful clinical judgment.

Implications:

  • This case underscores the importance of considering coronary artery anomalies in patients with SCAD.
  • Further research into optimal management strategies for SCAD in the context of anatomical variations is warranted.

Keywords:
AAOCA, anomalous aortic origin of a coronary arteryIVUS, intravascular ultrasonographyLVEF, left ventricular ejection fractionOCT, optical coherence tomographyPCI, percutaneous coronary interventionSCAD, spontaneous coronary artery dissectionanomalous coronary arteryintravascular ultrasonographymyocardial infarctionpercutaneous coronary interventionspontaneous coronary artery dissection

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