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Extensive spontaneous coronary artery dissection complicated by ventricular tachycardia storm and cardiogenic shock

Yen Wing Ng1, Lee Hill2, Alison Isobel Smyth2

  • 1Cardiology, Golden Jubilee National Hospital, Clydebank, UK yenwing.ng2@gjnh.scot.nhs.uk.

BMJ Case Reports
|August 12, 2026
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) in men, though rare, can cause life-threatening myocardial infarction. Conservative management, even with severe complications like cardiogenic shock, can lead to favorable outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous Coronary Artery Dissection (SCAD) is a rare cause of myocardial infarction.
  • It is more commonly seen in women, making cases in men particularly noteworthy.

Purpose of the Study:

  • To report a case of SCAD in a middle-aged man presenting with acute myocardial infarction.
  • To highlight the potential for severe complications and the efficacy of conservative management.

Main Methods:

  • Case report of a healthy man in his 40s with acute myocardial infarction.
  • Diagnostic workup included coronary angiography and intravascular ultrasound.
  • Management involved conservative therapy, medical treatment for complications, and device implantation.

Main Results:

  • The patient experienced ST-segment elevation myocardial infarction due to spontaneous dissection of the left anterior descending artery.
  • Complications included left ventricular systolic dysfunction, apical thrombus, ventricular tachycardia storm, and cardiogenic shock.
  • Clinical recovery was achieved with conservative management, and an implantable cardioverter-defibrillator was placed for secondary prevention.

Conclusions:

  • SCAD can present with life-threatening complications in men.
  • Conservative management, with multidisciplinary input, can lead to favorable outcomes in SCAD patients, even with severe presentations.

Keywords:
ArrhythmiasCardiogenic ShockHeart failureInterventional cardiologyIschaemic heart disease

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