Extracorporeal Membrane Oxygenation in Spontaneous Coronary Artery Dissection Complicated by Left Ventricular Free...

Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction, distinctly from atherosclerotic disease. Conservative management is typically recommended, but the incidence of mechanical complications is poorly defined, with only 7 cases reported. We describe a 62-year-old woman with SCAD complicated by left ventricular free wall rupture. Despite initial conservative management, she developed in-hospital cardiac arrest just moments before discharge and was treated with extracorporeal membrane oxygenation (ECMO), stabilizing her condition and enabling emergency surgical repair. This case underscores the potential role of ECMO in managing SCAD with life-threatening complications and underscores the need for a tailored approach to the management of SCAD patients, which differ from classical atherosclerotic myocardial infarction.