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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

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Concomitant coronary microvascular dysfunction and spontaneous coronary artery dissection resulting in ST-segment

Eldon Matthia1, Carl J Pepine2, Ellen C Keeley2

  • 1Department of Medicine, University of Florida, Gainesville, FL, USA.

Journal of Cardiology Cases
|January 26, 2022
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) can lead to myocardial infarction, even without epicardial disease. This case highlights the link between SCAD and coronary microvascular dysfunction, suggesting shared risk factors.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of acute coronary syndrome, particularly in women.
  • Coronary microvascular dysfunction (CMD) affects the heart's smallest arteries and can cause angina and ischemia.
  • The relationship between SCAD and CMD is not fully understood.

Observation:

  • A patient presented with recurrent angina and ST-elevation myocardial infarction despite having no obstructive epicardial coronary artery disease.
  • Coronary angiography revealed spontaneous coronary artery dissection and signs of coronary microvascular dysfunction.

Findings:

  • The patient's presentation suggests a potential association between SCAD and CMD.
  • Review of literature indicates overlapping risk factors and potential pathophysiological links between these two conditions.
  • Pathophysiology of SCAD and CMD involves distinct but potentially interconnected mechanisms.

Implications:

  • Recognizing the overlap in risk factors for SCAD and CMD is crucial for accurate diagnosis and management.
  • Further research is warranted to elucidate the definitive link and underlying mechanisms connecting SCAD and CMD.
  • This case underscores the importance of considering microvascular causes in patients with angina and non-obstructive coronary artery disease.

Keywords:
Coronary microvascular dysfunctionST-elevation myocardial infarctionSpontaneous coronary artery dissection

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