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A Case of Spontaneous Coronary Artery Dissection in the Setting of Exogenous Testosterone

Julita Gongolli1, Anna Vanderschaegen, Joseph A Prahlow

  • 1From the Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI.

The American Journal of Forensic Medicine and Pathology
|March 21, 2023
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. This case report highlights a potential unintended consequence of testosterone therapy in a transgender male patient.

Area of Science:

  • Cardiology
  • Endocrinology
  • Transgender Health

Background:

  • Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS).
  • SCAD involves intramural hemorrhage leading to a false lumen, compressing the coronary artery and impairing myocardial perfusion.
  • Known risk factors include pregnancy, young age, female sex, hormonal contraception, and other hormonal therapies.

Observation:

  • A case report of a 31-year-old transgender male (assigned female at birth) experiencing SCAD.
  • The patient was undergoing exogenous testosterone therapy.

Findings:

  • This case presents a potential link between testosterone therapy and SCAD.
  • It suggests testosterone therapy may be an additional risk factor for SCAD, particularly in transgender individuals.

Implications:

  • Raises awareness of rare adverse events associated with testosterone therapy.
  • Highlights the need for further research into the cardiovascular risks of hormone replacement therapy in transgender populations.
  • Emphasizes comprehensive risk assessment for SCAD in patients on hormonal therapies.

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