Spontaneous coronary artery dissection in mitral stenosis

Area of Science:

• Cardiology
• Vascular Biology
• Rheumatology

Background:

• Spontaneous coronary artery dissection (SCAD) is a rare condition, predominantly affecting young women, particularly during the peripartum or postpartum periods.
• SCAD is seldom diagnosed antemortem and has not previously been documented in conjunction with other non-ischemic cardiac conditions.

Observation:

• A unique case of SCAD was observed in a patient with pre-existing mitral stenosis.
• This presentation represents the first documented instance of SCAD co-occurring with mitral stenosis.

Findings:

• The patient underwent successful surgical intervention, including both valvular repair/replacement and coronary artery bypass grafting.
• The successful surgical management highlights the feasibility of treating complex SCAD cases.
• Rheumatic coronary arteritis is hypothesized as a potential underlying cause for the SCAD in this patient.

Implications:

• This case expands the known associations of SCAD, suggesting a potential link with valvular heart disease.
• The findings prompt further investigation into the etiology of SCAD, particularly the role of inflammatory processes like rheumatic coronary arteritis.
• Successful surgical outcomes in this complex case may inform future treatment strategies for patients with co-existing SCAD and valvular disease.