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Coronary Artery Disease III: Clinical Manifestations01:30

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SPONTANEOUS CORONARY ARTERY DISSECTION: CASE REPORTS OF THREE TYPES OF DISSECTION.

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  • 1Department of Cardiovascular Diseases, Clinical Hospital "Sveti Duh", Zagreb, Croatia.

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Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic tear causing acute coronary syndrome. This case series highlights diverse SCAD presentations and management strategies in different patient profiles.

Keywords:
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Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is a rare condition characterized by a tear in the coronary artery wall, distinct from atherosclerosis.
  • SCAD is more prevalent in younger women and can lead to acute coronary syndrome (ACS).

Observation:

  • Three distinct SCAD cases are presented: a male patient with exertional chest pain and STEMI, a young multiparous woman with ACS, and a postmenopausal woman with hypothyroidism.
  • Case 1 involved SCAD of the left anterior descending (LAD) artery treated with stenting.
  • Case 2 presented with extensive SCAD affecting the left main, left circumflex (LCx), and LAD arteries, managed with a two-stent technique.
  • Case 3 involved SCAD in the LCx, left main, and LAD arteries, with unclear etiology possibly linked to atherosclerotic lesions or hormonal changes.

Findings:

  • SCAD can manifest with varying clinical presentations and affect different coronary arteries.
  • Interventional treatment, including stenting, can be effective in managing SCAD-related ischemia and symptoms.
  • The role of hormonal changes in SCAD etiology warrants further investigation, particularly in postmenopausal women.

Implications:

  • This series underscores the importance of considering SCAD in patients presenting with ACS, especially younger individuals and women.
  • Diverse management strategies, from optimal medical therapy to percutaneous coronary intervention, may be employed based on SCAD extent and clinical presentation.
  • Further research is needed to elucidate the underlying mechanisms and optimize treatment protocols for SCAD.