Case 270: Spontaneous Coronary Artery Dissection Associated with Fibromuscular Dysplasia

Sutil-Vega, Mario; Vilar, Daniel Romeu; Barros-Membrilla, Antonio J; Millán, Xavier; Hidalgo, José A. Mainieri; Pons-Lladó, Ġuillem

doi:10.1148/radiol.2019170822

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Three patients reported excessive caffeine use before experiencing SCAD [30,45,53]. FMD was documented in 12 of 33 patients (36.4%) who were evaluated for this condition [14,20,26,38,56,63,73,99], none of whom had a known diagnosis of FMD before presenting with SCAD. All of the diagnosed FMD cases were in women.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Among the rest, cardiac computed tomography angiography (CCTA) was either used alone (n = 3) [55, 77,106] or followed by confirmatory angiography (n = 5) [32, 43, 51, 54, 70]. In general, 13 patients were initially misdiagnosed by coronary angiography [15,26,49,56,63,65,72,74,76,84,85,90,96] and subsequently secured a diagnosis of SCAD by either intravascular ultrasound (IVUS) (n = 2), optical coherence tomography (OCT) (n = 3) or repeated angiography (n = 8). Among patients with a correct diagnosis by angiography, SCAD was confirmed by IVUS and OCT for 16 and 11 cases, respectively.…”

Section: Diagnostic Imaging Modalitiesmentioning

confidence: 99%

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Spontaneous coronary artery dissection in patients with prior psychophysical stress: a systematic review of case reports and case series

Hosseini,

Fallahtafti,

Roudbari

et al. 2024

BMC Cardiovasc Disord

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Background Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of acute coronary syndrome, particularly in younger women. Due to limited information about SCAD, case reports and case series can provide valuable insights into its features and management. This study aimed to comprehensively evaluate the features of SCAD patients who experienced psychophysical stress before the SCAD event. Methods We conducted an electronic search of PubMed, Scopus, and Web of Science from inception until January 7, 2023. We included case reports or series that described patients with SCAD who had experienced psychophysical stress before SCAD. Patients with pregnancy-associated SCAD were excluded from our analysis. Results In total, we included 93 case reports or series describing 105 patients with SCAD. The average patient age was 44.29 ± 13.05 years and a total of 44 (41.9%) of patients were male. Among the included SCAD patients the most prevalent comorbidities were fibromuscular dysplasia (FMD) and hypertension with the prevalence of 36.4 and 21.9%, respectively. Preceding physical stress was more frequently reported in men than in women; 38 out of 44 (86.4%) men reported physical stress, while 36 out of 61 (59.1%) females reported physical stress (p value = 0.009). On the other hand, the opposite was true for emotional stress (men: 6 (13.6%)), women: 29 (47.6%), p value < 0.001). Coronary angiography was the main diagnostic tool. The most frequently involved artery was the left anterior descending (LAD) (62.9%). In our study, recurrence of SCAD due to either the progression of a previous lesion or new SCAD in another coronary location occurred more frequently in those treated conservatively, however the observed difference was not statistically significant (p value = 0.138). Conclusion While physical stress seems to precede SCAD in most cases, emotional stress is implicated in females more than males.

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Section: Patient Characteristicsmentioning

confidence: 99%

Section: Diagnostic Imaging Modalitiesmentioning

confidence: 99%

Spontaneous coronary artery dissection in patients with prior psychophysical stress: a systematic review of case reports and case series

Hosseini,

Fallahtafti,

Roudbari

et al. 2024

BMC Cardiovasc Disord

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“…CT angiographic findings of spontaneous coronary artery dissection include lack of atherosclerotic plaque, intramural hematoma, tapered luminal stenosis or occlusion, dissection flap, and perivascular fat stranding (3). This copy is for personal use only.…”

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confidence: 99%

Spontaneous Coronary Artery Dissection

Ufuk

Kılıç

2022

Radiology

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A rare cause of chest pain in paediatric age: a teenager with acute myocardial infarction due to spontaneous coronary artery dissection

et al. 2022

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A healthy 17-year-old boy was admitted to the emergency department presenting with a pressure-like sternal pain that started during exercise. His physical examination was normal. Twelve-lead ECG and transthoracic echocardiogram suggested a myocardial infarction. The patient was submitted to an invasive coronary angiography, which revealed a distal occlusion of the left anterior descending artery, due to a spontaneous coronary artery dissection. A balloon angioplasty was performed, with good results. Aetiological study did not discover any pathologic condition. Chest pain in paediatric age is a frequent complaint, despite not being usually caused by a serious condition. However, it is important to remember warning signs in order to diagnose life-threatening diseases, as soon as possible.

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Case 270: Spontaneous Coronary Artery Dissection Associated with Fibromuscular Dysplasia

Cited by 3 publications

References 13 publications

Spontaneous coronary artery dissection in patients with prior psychophysical stress: a systematic review of case reports and case series

Spontaneous coronary artery dissection in patients with prior psychophysical stress: a systematic review of case reports and case series

Spontaneous Coronary Artery Dissection

A rare cause of chest pain in paediatric age: a teenager with acute myocardial infarction due to spontaneous coronary artery dissection

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