Spontaneous Coronary Artery Dissection in a Young Man: A Case Report and Literature Review

BACKGROUND Spontaneous coronary artery dissection is a rare and underdiagnosed cause of acute coronary syndrome, primarily affecting women. The occurrence of spontaneous coronary artery dissection in the context of the absence of traditional atherosclerotic risk factors raises questions about the role of physical exertion or other stressors as potential triggers. Early recognition through clinical assessment and imaging is essential, as the therapeutic approach for spontaneous coronary artery dissection differs significantly from the treatment of traditional atherosclerotic acute coronary syndrome. Conservative management is often preferred for hemodynamically stable patients because interventional procedures have increased prevalence of complications in these patients. CASE REPORT This case report highlights an uncommon presentation of spontaneous coronary artery dissection in a 28-year-old man who presented with non-ST-elevation myocardial infarction following physical exertion. The diagnosis of spontaneous coronary artery dissection was confirmed via coronary angiography, revealing the classic findings of dissection without significant atherosclerosis. Management was conservative, as the patient was hemodynamically stable, with close monitoring and medical therapy, including antiplatelet agents and beta-blockers. CONCLUSIONS This case challenges the prevailing gender assumptions associated with spontaneous coronary artery dissection and highlights the need for increased awareness of spontaneous coronary artery dissection in males. Additionally, it suggests the potential role of physical stressors in precipitating spontaneous coronary artery dissection. Further research into the pathophysiology of spontaneous coronary artery dissection in different populations is warranted.