Spontaneous coronary artery dissection in men presenting with acute coronary syndrome, successfully managed by intravascular ultrasound-guided percutaneous coronary intervention

Thomas, Bethan Nia; Aslam, Sajid; Cullen, James; Anantharaman, R

doi:10.1136/bcr-2013-009169

Cited by 4 publications

(12 citation statements)

References 15 publications

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“…Nine of these patients were male and the mean age at the time of dissection was 36 years of age ranging from 17 to 53 years. The risk factors each patient had were analyzed; 30.7% were smokers, 30% had high cholesterol and 15.3% had a family history of ischemic heart disease [1,[3][4][5][6][7][8][9][10][11][12]. Obesity was identified as a further risk factor in one of these patients [5].…”

Section: Discussionmentioning

confidence: 99%

“…The remaining 6 patients were found to have no risk factors for coronary artery disease or risk factors were not declared. The female to male ratio of these 6 patients was equal [1,3,7,8,10,13].…”

Section: Discussionmentioning

confidence: 99%

“…From literature reviewed, seven cases (53.8%) were associated with aerobic activity and five cases (38.4%) were associated with anaerobic activity disease [1,[3][4][5][6][7][8][9][10][11][12]. One further case that was found was associated with severe emotional distress and anxiety [3].…”

Section: Discussionmentioning

confidence: 99%

“…One further case that was found was associated with severe emotional distress and anxiety [3]. Additionally, five patients had delayed presentation after the initial event, the longest delay in presentation being a patient who presented following a cycling tour who had suffered angina pain for four months but had not sought medical attention [9].…”

Section: Discussionmentioning

confidence: 99%

“…The left anterior descending artery was the vessel most commonly affected with eight of the cases in literature review involving this artery alone [3-6, 8, 9, 12]. Three further cases involved only the circumflex artery and finally two cases involved multiple coronary vessels [1,3,7,10,11].…”

Section: Discussionmentioning

confidence: 99%

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Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

Ellis¹,

Grey²,

D'Sa³

et al. 2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comExercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report Paul Ellis, Victoria Grey, Anthony D'Sa, Derek Connolly ABSTRACT Introduction: Spontaneous coronary artery dissection (SCAD) is an unusual cause of chest pain most often presenting in peripartum or postpartum women. The SCAD precipitated by exercise in patients without underlying atherosclerosis is very rare and has been described in literature only on a few occasions. It has never been described in a male above the age of 40. Case Report: We present the case of a 54-year-old male presented with acute ST elevation myocardial infarction having suffered a left anterior descending artery dissection following an intense gym workout. He was successfully managed with coronary stenting. The patient suffered from on-going chest pain after initial recovery and was investigated with CT coronary angiography to assess stent patency and for evidence of underlying coronary artery disease. This showed a calcium score of 0 and no evidence of underlying atherosclerosis with a patent stent. Conclusion:In conclusion, SCAD should be considered in the differential diagnosis of patients presenting with acute coronary syndrome, even those without coronary risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

Ellis¹,

Grey²,

D'Sa³

et al. 2016

IJCRI

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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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Repeat stent implementation for recanalization of the proximal right coronary artery: a case report

et al. 2018

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BackgroundA stent in a false lumen is a common cause of stent occlusion after coronary percutaneous coronary artery intervention therapy, particularly in the culprit lesion of acute myocardial infarction. Here, we present an unusual case of successful recanalization of the proximal right coronary artery with implementation of another stent to crush the previous stent in the false lumen.Case presentationA 40-year-old Chinese man underwent coronary stent implementation in the proximal right coronary artery due to acute inferior wall myocardial infarction at another hospital. Six months later, he underwent coronary angiography re-examination for recurrent symptomatic angina at our hospital. Coronary angiography and intravascular ultrasound confirmed that the previous stent was deployed in the false lumen of the right coronary artery. Then, intravascular ultrasound was used to guide the wire to re-enter the true lumen of the proximal right coronary artery, and another stent was deployed into the true lumen to crush the previous stent.ConclusionIntravascular ultrasound proved to be a pivotal tool in confirming false or true lumen, as well as determining favorable proximal site entry points to avoid rewiring the mesh of the previous stent.

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Spontaneous coronary artery dissection in men presenting with acute coronary syndrome, successfully managed by intravascular ultrasound-guided percutaneous coronary intervention

Cited by 4 publications

References 15 publications

Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report

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

Repeat stent implementation for recanalization of the proximal right coronary artery: a case report

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