Spontaneous Coronary Artery Dissection Presenting as Electrical Storm: A Case Report

Area of Science:

• Cardiology
• Emergency Medicine

Background:

• Spontaneous coronary artery dissection (SCAD) is a key cause of myocardial infarction in younger individuals lacking traditional atherosclerotic risk factors.
• SCAD can manifest as life-threatening ventricular arrhythmias like ventricular tachycardia (VT) or ventricular fibrillation (VF), collectively termed electrical storm (ES).

Purpose of the Study:

• This report details a case of SCAD presenting as ES in a young, healthy male.
• To highlight the importance of considering SCAD in patients with unexplained cardiac events and ES.

Main Methods:

• A case report of a 38-year-old male experiencing chest pain during exercise, leading to cardiac arrest and ES.
• Diagnosis of SCAD in the left anterior descending artery was confirmed and treated with stenting.
• Patient management included Advanced Cardiac Life Support and defibrillation.

Main Results:

• The patient presented with ES refractory to initial resuscitation efforts.
• Successful stenting of the SCAD lesion was performed.
• The patient recovered neurologically intact after a 13-day hospitalization.

Conclusions:

• Electrical storm is a critical manifestation of SCAD.
• Emergency physicians must maintain a high index of suspicion for SCAD in patients presenting with acute coronary syndrome or ES, especially younger individuals without risk factors.
• Timely diagnosis and intervention for SCAD are crucial for favorable outcomes.