Multivessel Spontaneous Coronary Artery Dissection in the Setting of Anomalous Left Coronary Arteries

Area of Science:

• Cardiology
• Vascular Biology

Background:

• Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic, non-traumatic, non-iatrogenic dissection of epicardial coronary arteries.
• The pathogenesis of SCAD remains incompletely understood.
• The relationship between SCAD and coronary artery anomalies is not well-established.

Purpose of the Study:

• To present a unique case of multivessel SCAD.
• To explore the association between SCAD and anomalous coronary artery origin.
• To discuss the management of SCAD in this specific anatomical context.

Main Methods:

• Case report presentation.
• Review of clinical presentation and diagnostic findings.
• Discussion of treatment and management strategies.

Main Results:

• A 64-year-old woman presented with non-ST-elevation myocardial infarction (NSTEMI).
• The patient was diagnosed with multivessel SCAD.
• All three coronary arteries (RCA, LAD, LCx) originated from the right sinus of Valsalva, a rare coronary artery anomaly.

Conclusions:

• SCAD can coexist with complex coronary artery anomalies, such as the origin of all three coronary arteries from the right coronary cusp.
• A potential association exists between SCAD and coronary artery anomalies.
• Effective treatment and management strategies are crucial for multivessel SCAD in the setting of anomalous coronary artery origins.