Spontaneous Coronary Artery Dissection: Less Is More!
Mehdi Saighi Bouaouina1, Pascal Motreff2, Mohamed Mehdi Boussaada3
1Interventional Cardiology Department, European Hospital of Paris-La Roseraie, Aubervilliers, France.
JACC. Case Reports
|July 28, 2021
Insights
Spontaneous coronary artery dissection (SCAD) is a rare cause of heart attack. This case highlights SCAD of the right coronary artery, diagnosed with imaging and guiding treatment.
Area of Science:
- Cardiology
- Cardiovascular Diseases
- Interventional Cardiology
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial infarction (AMI).
- It often affects younger women and can present as acute coronary syndrome (ACS).
- Prompt diagnosis and appropriate management are crucial for favorable outcomes.
Purpose of the Study:
- To report a case of acute coronary syndrome (ACS) caused by spontaneous coronary artery dissection (SCAD).
- To illustrate the diagnostic process and treatment strategy guided by advanced imaging in a SCAD case.
- To emphasize the importance of considering SCAD in the differential diagnosis of ACS.
Main Methods:
- Clinical presentation of acute coronary syndrome.
- Coronary angiography for initial diagnosis of coronary artery dissection.
- Optical coherence tomography (OCT) for detailed visualization and treatment guidance.
Main Results:
- Diagnosis of SCAD of the right coronary artery confirmed.
- OCT provided critical information for guiding the interventional strategy.
- Successful management based on imaging findings.
Conclusions:
- SCAD is a relevant cause of ACS that requires specific diagnostic and therapeutic approaches.
- Optical coherence tomography plays a vital role in SCAD diagnosis and management.
- This case underscores the importance of a high index of suspicion for SCAD in ACS patients.
Abstract:
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction (ACS). We report a case of acute coronary syndrome due to SCAD of the right coronary artery. Diagnosis was based on clinical presentation and coronary angiography, and confirmed by optical coherence tomography which guided our treatment strategy. (Level of Difficulty: Beginner.).
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