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Spontaneous coronary artery dissection in a patient with a progestin-releasing intrauterine device

Enad Haddad1, Sudeep Nugooru1, Tyler Lee1

  • 1Department of Internal Medicine, Jefferson Abington Hospital, Abington, PA, USA.

Global Cardiology Science & Practice
|March 30, 2026
PubMed

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS), which predominantly affects women. This case report describes a 55-year-old female with SCAD potentially linked to a progestin-releasing intrauterine device (IUD) placed 1.5 years ago. The patient presented with acute chest pain and diaphoresis, and was eventually found to have ST-elevation myocardial infarction that led to coronary angiography, revealing type 1 SCAD from the proximal right coronary artery (RCA) to the mid-RCA with grade 3 thrombolysis in myocardial infarction (TIMI) flow distally. She was managed conservatively with antithrombotics, statins, and blood pressure control, achieving favorable outcomes without invasive intervention. The IUD was removed due to its potential role as a hormonal trigger. This case underscores the importance of considering SCAD in women presenting with ACS, particularly in those with hormonal risk factors.

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