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Case Report on Spontaneous Coronary Artery Dissection: A Rare Culprit of Chest Pain

Aiman D Khudair1, Thuraiya H Al-Rawahia1, Rachel A Marshall1

  • 1Department of Cardiology, Royal College of Surgeons in Ireland - Bahrain, Muharraq, BHR.

Cureus
|November 29, 2023
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) is a rare condition causing chest pain, often in women. This case highlights conservative management with dual-antiplatelet therapy leading to successful resolution.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic arterial wall separation leading to intramural hematoma.
  • SCAD predominantly affects young to middle-aged women, often in the peripartum period, and is associated with fibromuscular dysplasia (FMD).

Observation:

  • Patients typically present with chest pain, shortness of breath, nausea, and vomiting.
  • Coronary angiography is the primary diagnostic tool for SCAD.
  • This case involved a 54-year-old woman presenting with SCAD symptoms.

Findings:

  • The patient was diagnosed with SCAD via coronary angiography.
  • Conservative management, including dual-antiplatelet therapy, was initiated.
  • The patient experienced a complete resolution of SCAD.

Implications:

  • Conservative management is a viable option for SCAD, even in older women.
  • Dual-antiplatelet therapy appears effective in managing SCAD.
  • Further research into SCAD pathogenesis and optimal treatment strategies is warranted.

Keywords:
acute coronary syndromechest paincoronary angiographynon st-elevation myocardial infarctionspontaneous coronary artery dissection

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