Von willbrand syndrome remains a rare pathology. Its etiologies and clinical manifestations are varied. This syndrome can be inherited or acquired. The acquired form is associated with various pathologies (Gastric, mechanical support system…) including cardiovascular diseases such as aortic stenosis, HCM, and Mitral regurgitation. Nevertheless, the association of acquired Willebrand syndrome with coronary pathology remains a rare association. In this literature review, we have made a review of the various articles addressing this subject. The management of ACS in patients with AvWS follows that of normal patients in terms of interventional procedure, however therapeutic drug management remains delicate given the hemorrhagic risk that these drugs present. The use of DAPT and heparin is possible while thrombolysis remains at very high risk for the patient. The use of desmopressin can be done with caution and also factor VIII and vWF concentrates have their place to reduce the risk of bleeding. Overall, the collaboration of the cardiologist and hematologist remains essential for better management of these patients.
Introduction and Importance: Spontaneous coronary artery dissection (SCAD) is often revealed by an acute coronary syndrome classified then as a MINOCA. The typical patient is a female patient with no or few cardiovascular risk factor. Our work aims to illustrate the effectiveness of medical treatment in patients with SCAD. Case Report: We report a case of a 56-year-old female patient who was admitted after 3 days of infarct-like thoracic pain related to an anterior extended ST-elevation myocardial infarction. The coronarography showed a SCAD of the left anterior descending coronary artery. The patient was discharged under medical treatment. Six weeks later, coronarography showed a perfused coronary artery. Discussion: Most cases of SCAD present as acute coronary syndrome. Coronary angiography remains the ‘first-line’ examination. The use of endocoronary imaging such as IVUS and optical coherence tomography is necessary in case of diagnostic doubt (especially in SCAD type 2 and 3). The optimal management of SCAD remains unclear. A conservative approach should be the preferred strategy. Conclusion: SCAD should be considered in any young woman presenting with suspicious chest pain with positive troponin. The diagnosis is initially angiographic and may require endocoronary imaging for greater accuracy. Conservative treatment remains the best option.
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