Spontaneous Left Main Coronary Artery Dissection in a Male.

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Spontaneous coronary artery dissection (SCAD) is an underrecognized cause of acute coronary syndrome (ACS), typically affecting younger women.
• This case report details a rare instance of SCAD in a 46-year-old male involving the left main coronary artery.

Observation:

• The patient presented with high-risk ACS, necessitating emergency coronary angiography and percutaneous coronary intervention (PCI) of the left main artery.
• Intramural hematoma extension post-PCI confirmed SCAD, despite the patient being male and lacking typical risk factors.

Findings:

• Coronary angiography is the gold standard for SCAD diagnosis, often complemented by optical coherence tomography (OCT) and intravascular ultrasound (IVUS).
• While systemic connective tissue disease was suspected, genetic analysis revealed no reportable variants.
• This case underscores SCAD as a potential cause of ACS in men.

Implications:

• Recognizing SCAD in men is crucial for timely and accurate diagnosis and management, which differs from other ACS etiologies.
• Coronary angiography findings are key to diagnosing SCAD, guiding appropriate treatment strategies.