Recurrent Spontaneous Coronary Artery Dissections in a Male Patient With Fibromuscular Dysplasia

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome, typically affecting young to middle-aged women.
• While less common in men, SCAD can occur in younger males, sometimes without traditional cardiovascular risk factors.
• Fibromuscular dysplasia (FMD) is an associated condition that may increase the risk of SCAD recurrence, even in men.

Observation:

• This report details a case of a young man with a history of FMD and previous SCAD in multiple coronary arteries.
• The patient presented with exertional chest pain, indicative of myocardial ischemia.
• Recurrent SCAD was diagnosed in the distal right coronary artery despite ongoing conservative management with aspirin and beta-blockers.

Findings:

• Recurrent SCAD can occur in young men with FMD, even under optimal medical therapy.
• The presentation of exertional chest pain in this case signaled a significant cardiovascular event.
• This case underscores the potential for SCAD recurrence in specific male populations.

Implications:

• Further investigation into the pathophysiology of SCAD and its association with FMD in men is crucial.
• Developing targeted medical therapies for recurrent SCAD in men is a significant unmet need.
• This case highlights the importance of considering SCAD in young men presenting with acute coronary syndromes, especially with a history of FMD.