Book review
https://doi.org/10.20471/acc.2024.63.s1.6
Spontaneous Coronary Artery Dissection: Case Reports of Three Types of Dissection
Jozica Šikić
; Department of Cardiovascular Diseases, Clinical Hospital “Sveti Duh”, Zagreb, Croatia
*
Jasna Čerkez Habek
; Department of Cardiovascular Diseases, Clinical Hospital “Sveti Duh”, Zagreb, Croatia
Dean Strinić
; Department of Cardiovascular Diseases, Clinical Hospital “Sveti Duh”, Zagreb, Croatia
Petar Bešlić
; Department of Cardiovascular Diseases, Clinical Hospital “Sveti Duh”, Zagreb, Croatia
Petra Potrebica
; School of Medicine of the University of Zagreb
* Corresponding author.
Abstract
Spontaneous coronary artery dissection (SCAD) is defined as a nonatherosclerotic,
nontraumatic or iatrogenic tear within the epicardial coronary artery wall creating a false lumen or hematoma.
It is more common in younger patients and women and it can cause acute coronary syndrome
(ACS) in 0.1 to 4 percent of cases. We described three cases of different types of SCAD. In the first case,
we described a male patient admitted due to chest pain after excessive physical activity. Electrocardiogram
(ECG) showed inferior ST-elevation myocardial infarction (STEMI). SCAD of left anterior descending
(LAD) was found by coronary angiography. Because of chest pain and signs of ischemia on ECHO, a
stent was implanted. After procedure, the patient was pain-free and hemodynamically and rhythmically
stable. In the second case, we presented a young multiparous woman with signs of acute coronary syndrome
(ACS). A coronary angiogram showed a homogeneous stenosis of proximal LAD. Optimal medical
therapy (OMT) was the initial therapy of choice. After a few days due to the recurrence of chest pain
and an increase in troponin level, recoronarography was performed. It showed a dissection of the left main
(LM), left circumflex artery (LCx) and LAD. It was treated with the two-stent technique procedure, after
which, the patient was stable and pain free. In the third case, we showed a postmenopausal patient with
subclinical hypothyroidism. In this case, it is difficult to say whether the dissections of LCx, LM and LAD
that occurred after the balloon dilatation of LCx and the stent implantation in the right coronary artery
(RCA) were result of atherosclerotic lesions or hormonal changes that can cause SCAD.
Keywords
Spontaneous coronary artery dissection; Acute coronary syndrome
Hrčak ID:
320949
URI
Publication date:
1.3.2024.
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