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Delayed cardiogenic shock following spontaneous coronary artery dissection in a young, healthy female: a case report

Leili Abdan1, Maria Saadatian2, Homina Saffar3

  • 1Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Medical Case Reports
|May 15, 2026
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) can affect young women without risk factors. Early recognition and multidisciplinary care are vital for managing this rare cause of acute coronary syndrome.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is a rare, non-atherosclerotic cause of acute coronary syndrome.
  • It predominantly affects young, healthy women lacking traditional cardiovascular risk factors.
  • Variable presentations and diagnostic challenges exist, especially with unremarkable initial findings.

Purpose of the Study:

  • To report a case of SCAD in a young woman.
  • To emphasize the importance of considering SCAD in specific patient demographics.
  • To highlight diagnostic and management considerations for SCAD.

Main Methods:

  • Case presentation of a 37-year-old Iranian woman with no prior medical history or cardiovascular risk factors.
  • Initial presentation with non-specific symptoms and a normal ECG.
  • Management included intensive medical care, hemodynamic support, and coronary angiography confirming SCAD.

Main Results:

  • The patient experienced rapid progression to cardiogenic shock with ventricular arrhythmias.
  • Coronary angiography confirmed spontaneous coronary artery dissection.
  • Cardiac function improved with multidisciplinary care and hemodynamic support.

Conclusions:

  • Clinicians must consider SCAD in young women with chest pain, irrespective of risk factors or initial test results.
  • Early recognition is crucial for timely intervention.
  • A multidisciplinary approach is essential for optimizing outcomes in SCAD patients.
Abstract

Keywords:
Acute coronary syndromeCardiogenic shockChest painMyocardial infarctionSpontaneous coronary artery dissection

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