Recurrent Spontaneous Coronary Artery Dissection as the Cause of Repeated Myocardial Infarctions
Arnon Møldrup Knudsen1, Nicolaj Brejnholt Støttrup2, Henrik Hager1
1Department of Pathology Aarhus University Hospital Aarhus Denmark.
Clinical Case Reports
|January 13, 2025
Summary
Spontaneous coronary artery dissection (SCAD) is a serious condition causing heart attacks. This case details a fatal outcome from recurrent SCAD, emphasizing its diagnostic importance in women.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) involves intramural hematoma leading to coronary artery obstruction.
- SCAD is an important cause of myocardial infarction, particularly in younger women.
Purpose of the Study:
- To present a case of recurrent SCAD with a fatal outcome.
- To highlight the diagnostic considerations for SCAD in patients presenting with myocardial infarction.
Main Methods:
- Case report of a 51-year-old female with acute myocardial infarction and cardiogenic shock.
- Diagnosis of severe SCAD affecting the proximal left coronary artery.
- Management involved complex percutaneous coronary intervention with stent insertion and revascularization.
Main Results:
- The patient experienced cardiac arrest during intervention, requiring cardiopulmonary support.
- Post-intervention, severe heart failure and multiple organ failure developed.
- The patient ultimately died due to complications of recurrent SCAD.
Conclusions:
- Recurrent SCAD can lead to severe complications and mortality.
- SCAD should be considered in the differential diagnosis of myocardial infarction in female patients.
- This case underscores the critical need for timely SCAD diagnosis and management.
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