Spontaneous coronary artery dissection as a cause of myocardial infarction

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare disease that is usually seen in young women in left descending coronary artery and result in events like sudden cardiac death and acute myocardial infarction. A 70-year-old man was admitted to the emergency department with chest pain which started 1 h ago during a relative's funeral. The initial electrocardiography demonstrated 2 mm ST-segment depression in leads V1-V3 and the patient underwent emergent coronary angiography. SCAD simultaneously in two different coronary arteries [left anterior descending (LAD) artery and left circumflex (LCx)] artery was detected and SCAD in LCx artery was causing total occlusion which resulted in acute myocardial infarction. Successful stenting was performed thereafter for both lesions. In addition to the existence of SCAD simultaneously in two different coronary arteries, the presence of muscular bridge and SCAD together at the same site of the LAD artery was another interesting point which made us report this case.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words:Coronary artery dissection; Myocardial bridge; Myocardial infarction; Coronary artery disease; Acute coronary syndrome Core tip: In this case report, we discussed a patient who had a rare disease called spontaneous coronary artery dissection simultaneously in two different coronary arteries causing acute myocardial infarction. The presence of muscular bridge and spontaneous coronary artery dissection together at the same site of the left anterior descending artery was another interesting point which made us report this case.Aksakal A, Arslan U, Yaman M, Urumdaş M, Ateş AH. Spontaneous coronary artery dissection as a cause of myocardial infarction. World

Prevalence and three-year follow-up of patients with isolated myocardial bridge in the mid-Black Sea region: a retrospective single-center study

“…Although implantation has been reported, it carries a high risk of stent restenosis. [25][26][27] While these treatment options are in practice, no precise guidelines are available.…”

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

“…A total of 11.4% of patients had mental health disorders, including depression, anxiety disorder, attention deficit and hyperactivity disorder (ADHD), and posttraumatic stress disorder (PTSD). In terms of congenital anomalies, one patient had an anomalous origin of the coronary artery [58], and two patients had myocardial bridging [60,95]. Heart failure and alcohol consumption were not reported in any patients.…”

“…While the majority of patients had SCAD of a single artery, seven patients had multivessel SCAD [59,63,66,86,95,99,103], with the involvement of four (n = 1), three (n = 3), and two (n = 4) arteries. The most frequently dissected artery was the left anterior descending artery (LAD) (n = 70), followed by the right coronary artery (RCA) (n = 16), LCx (n = 10), and left main coronary artery (LMCA) (n = 6).…”

Role of risk stratification and genetics in sudden cardiac death

“…The remaining 5% -10% of SCDs are attributed to electrical or congenital (prolonged QT syndrome, Brugada syndrome (Korte et al 2015), catecholaminergic polymorphic ventricular tachycardia, coronary anomalies, cyanotic/noncyanotic diseases) abnormalities of heart (Figure 3). Spontaneous coronary artery dissection in the left descending coronary artery and anomalous origin of the left coronary artery from the pulmonary artery can also precipitate SCD (Aksakal et al 2014; et al 2015). Dilatation of a coronary artery segment to a diameter of more than 1.5-fold its normal size is defined as coronary artery aneurysm (CAA), and contained rupture of mycotic CAA in the left circumflex coronary artery has been reported as a cause of myocardial ischemia (MI) or SCD (Joshi et al 2015).…”