Spontaneous coronary artery dissection in a young man with anterior myocardial infarction

Yeoh, J.; Choo, Hock-Heng; Soo, Chun Ian; Lim, Yu Liang; Yan, Chee‐Hong

doi:10.1002/ccd.1810240310

Cited by 13 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of these dissections was incident to cocaine inhalation and smoking [15]. Another, in a 20-year-old man with a spontaneous left anterior descending coronary artery dissection, involved abrupt total occlusion of the vessel distally and remote from the dissection, thought to be secondary to embolization of thrombus from the dis sected area [16], Behnam and Tillinghast [17] described a spontaneous left anterior descending dissection present- 74 Laslett/Gregoratos…”

Section: Discussionmentioning

confidence: 99%

Unique Spontaneous Coronary Artery Dissection in an Elderly Woman

Laslett

Gregoratos²

1995

Cardiology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Unique Spontaneous Coronary Artery Dissection in an Elderly Woman

Laslett

Gregoratos²

1995

Cardiology

View full text Add to dashboard Cite

show abstract

“…Coronary dissection also occurs in conjunction with aortic dissection and involves the RCA more often than the left. Histological examinations have shown a variety of abnormalities [ 38,40,42,45 ] . The most common observation is a hematoma within the arterial media and luminal compression ( Fig.…”

Section: Spontaneous Coronary Artery Dissectionmentioning

confidence: 99%

“…The most common observation is a hematoma within the arterial media and luminal compression ( Fig. 20.3 ) [ 38,42 ] . A rent in the intima leading to the medial hematoma is observed inconsistently, as are changes of cystic medial necrosis [ 40 ] .…”

Section: Spontaneous Coronary Artery Dissectionmentioning

confidence: 99%

“…Isolated spontaneous coronary artery dissection is a rare event that occurs in all coronary arteries with approximately equal incidence [37][38][39][40][41][42] . It occurs most frequently in young women, particularly in the peripartum period, but may be associated with blunt chest trauma, atherosclerosis (possibly related to plaque rupture), obstruction immediately above the aortic valve (e.g., an obstructed prosthetic ball valve), and from iatrogenic complications of coronary artery cannulation [ 38,[43][44][45][46][47] .…”

Section: Spontaneous Coronary Artery Dissectionmentioning

confidence: 99%

See 1 more Smart Citation

Nonatherosclerotic Ischemic Heart Disease

Valeti

Wilson

Vlodaver

2011

Coronary Heart Disease

View full text Add to dashboard Cite

Spontaneous coronary vasospasm leads to an anginal syndrome (often referred to as Printzmetal angina), occurring at rest or with exertion. Coronary spasm occurs in two broad settings -spasm associated with atherosclerosis or other arterial diseases, and spasm that occurs in the absence of identifiable arteriopathy [1][2][3][4][5] . The former is common, but the latter is not [ 1 ] . Bertrand administered ergonovine, a compound that precipitates spasm in predisposed individuals, to 1,089 patients undergoing coronary arteriography and found that spasm was relatively common in patients with recent coronary thrombosis ( Fig. 20.1 ) [ 3 ] . Vasospasm could be induced in 20% of patients with a recent infarction and 38% of patients with unstable or rest angina, but in only 4.3% of patients with stable, exertional angina. Equally important, only 1.2% of patients with chest pain atypical for angina had inducible spasm, emphasizing that spasm is not a common cause of atypical chest pain.Patients with inducible vasospasm and a significant (>75%) stenotic lesion have a higher incidence of death, infarction, and atherosclerosis progression than patients with isolated stenotic lesions without inducible vasospasm or vasospasm alone [6][7][8] . Harding et al. [ 9 ] retrospectively analyzed ergonovine provocative studies and found that smoking (odds ratio 4.7-7.7:1 compared to nonsmokers) and atherosclerosis were significant risk factors for inducible spasm [ 9,10 ] . More recently, vascular inflammation, polymorphism of eNOS genes, and enhanced phospholipase C activity have been linked to coronary spasm [ 11,12 ] . The diagnosis of coronary vasospasm can be made at the time of angiography by giving drugs that provoke spasm or occasionally by observing spontaneous spasm [ 1,2,[13][14][15][16][17][18] . The most commonly administered agent is an ergot derivative, usually ergonovine maleate or ergometrine, although methacholine was used to induce vasospasm in pioneering studies in the catheterization laboratory. Ergot derivatives are potent constrictors of vascular smooth muscle. Muscarinic receptor agonists (acetylcholine and methacholine) appear to cause vasospasm in a large fraction of patients with ergonovine-induced spasm [ 19 ] . Other agents have also been reported to induce spasm (cold pressor test, histamine, hyperventilation), but not enough information is known to assess the potency and specificity of these agents [ 20,21 ] .Prior to a provocative test for vasospasm, an electrocardiogram should be obtained and a coronary arteriogram should show the absence of severe coronary obstruction. When vasospasm is suspected, acetylcholine or ergonovine generally is given in incremental intravenous doses -starting at 50 m g and increasing doses until a total dose of 350-400 m g intravenously is reached for ergonovine. Although ergonovine appears safe in doses up to 800 m g, the vast majority of patients

show abstract

“…The dissection may be complicated by total thrombotic coronary occlusion. Distal emboli with abrupt vessel cut-offs are common [ 442 ]. Unless complicated by lumen thrombosis or death, most spontaneous dissections heal, but permanent true and false channel lumens may persist [ 437 , 448 , 449 , 449a ].…”

Section: Spontaneous Coronary Artery Dissectionmentioning

confidence: 99%

Coronary Angiography

Wilson

2015

Coronary Artery Disease

View full text Add to dashboard Cite

Spontaneous coronary artery dissection in a young man with anterior myocardial infarction

Cited by 13 publications

References 9 publications

Unique Spontaneous Coronary Artery Dissection in an Elderly Woman

Unique Spontaneous Coronary Artery Dissection in an Elderly Woman

Nonatherosclerotic Ischemic Heart Disease

Coronary Angiography

Contact Info

Product

Resources

About