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The Destabilized Artery: A Case of Spontaneous Coronary Artery Dissection Presenting as Unstable Angina

Ebubechukwu Ezeh1, Esiemoghie J Akhigbe1, Olusola Olubowale2

  • 1Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

Cureus
|February 2, 2022
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of acute coronary syndrome (ACS). Medical management is the preferred initial treatment due to lower success rates with percutaneous intervention in SCAD patients.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is an emerging cause of acute coronary syndrome (ACS).
  • Increased recognition is linked to advances in diagnostic imaging.
  • SCAD occurs in patients with and without traditional cardiovascular risk factors.

Observation:

  • Chest pain or discomfort is the most common presentation.
  • Normal troponin levels do not exclude SCAD.
  • Coronary angiography is essential for definitive diagnosis.

Findings:

  • Percutaneous intervention (PCI) for SCAD has lower success rates than for atherosclerotic disease.
  • Medical management is the recommended initial treatment strategy for SCAD.

Implications:

  • Enhanced diagnostic capabilities are improving SCAD detection.
  • Understanding SCAD's unique characteristics is crucial for effective treatment.
  • Further research may optimize management strategies for SCAD patients.

Keywords:
acute coronary syndromecardiovascularcoronary artery angiographyelectrocardiogram (ecg/ekg)left heart catheterizationspontaneous coronary artery thrombosistroponinunstable angina

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