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Spontaneous Coronary Artery Dissection: A Challenging Diagnosis
Sayna Poursdarolah1, Mariam Seliman1, Jonathan Abaya Ghazaleh1
1Internal Medicine, Eisenhower Medical Center, Rancho Mirage, USA.
Cureus
|November 29, 2023
Summary
Spontaneous coronary artery dissection (SCAD) can affect individuals with cardiac risk factors, not just those without. Early clinical suspicion is key for accurate diagnosis and appropriate conservative management.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome.
- SCAD is primarily reported in postpartum patients and those lacking typical cardiac risk factors.
Observation:
- A 58-year-old female with diabetes, hypertension, and hyperlipidemia presented with chest pain and ST elevation.
- Cardiac catheterization revealed spontaneous dissection of the obtuse marginal artery.
Findings:
- The patient's SCAD was successfully managed conservatively.
- Distinguishing SCAD from coronary artery occlusion is challenging, and revascularization carries risks.
Implications:
- SCAD should be considered in patients with and without traditional cardiac risk factors.
- High clinical suspicion is essential for diagnosing SCAD.
- Conservative management may be preferred due to potential complications of revascularization in SCAD.
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