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Triple-Vessel Spontaneous Coronary Artery Dissection Managed Conservatively.
Garen S Kroshian1, Matthew J Cozzolino2, Edeliz Flores2
1Department of Internal Medicine, Boston Medical Center, Boston, Massachusetts, USA.
Case Reports in Cardiology
|December 30, 2024
Summary
Spontaneous coronary artery dissection (SCAD) can affect multiple arteries. Conservative management led to complete recovery in a SCAD patient affecting the LAD, OMs, and RCA.
Area of Science:
- Cardiology
- Vascular Medicine
- Interventional Cardiology
Background:
- Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of myocardial infarction, particularly in women.
- Management strategies for SCAD remain debated due to its complex and often unpredictable nature.
Observation:
- A 54-year-old woman presented with SCAD affecting three major coronary territories: left anterior descending artery (LAD), obtuse marginals (OMs), and right coronary artery (RCA).
- The dissection involved distal LAD, a diagonal branch, first and second OMs, and the mid-RCA.
Findings:
- The patient was managed conservatively without any percutaneous coronary intervention or surgical revascularization.
- Follow-up coronary angiography revealed complete resolution of the SCAD and restoration of normal coronary anatomy.
Implications:
- This case highlights the potential efficacy of conservative management for multi-territory SCAD.
- Complete angiographic recovery suggests favorable natural healing processes in select SCAD cases.
- Further research into optimal SCAD management pathways is warranted.
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