Conservative management of spontaneous coronary artery dissection: a case report

Pan Afr Med J. 2020 Aug 25:36:334. doi: 10.11604/pamj.2020.36.334.25546. eCollection 2020.

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes (ACS) that mainly occurs in young women with no risk factors and no coronary atherosclerosis. Diagnosis is made by invasive coronary angiography (CA), computed tomography coronary angiography (CTCA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The rarity of this entity as well as the complications of invasive treatment make it difficult to choose therapy between conservative management, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). We report a case of a 36-year-old woman presented with non ST elevation myocardial infarction (NSTEMI) related to spontaneous dissection of coronary arteries (left main trunk, left anterior descending artery and left circumflex artery) treated medically with spectacular results at 2 months, controlled by CTCA.

Keywords: Spontaneous coronary artery dissection; acute coronary syndromes; case report; conservative management.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Aspirin / therapeutic use
  • Computed Tomography Angiography
  • Conservative Treatment / methods*
  • Coronary Angiography
  • Coronary Vessel Anomalies / complications
  • Coronary Vessel Anomalies / diagnosis
  • Coronary Vessel Anomalies / therapy*
  • Echocardiography
  • Female
  • Humans
  • Non-ST Elevated Myocardial Infarction / diagnosis
  • Non-ST Elevated Myocardial Infarction / therapy
  • Platelet Aggregation Inhibitors / therapeutic use
  • Vascular Diseases / complications
  • Vascular Diseases / congenital*
  • Vascular Diseases / diagnosis
  • Vascular Diseases / therapy

Substances

  • Adrenergic beta-Antagonists
  • Platelet Aggregation Inhibitors
  • Aspirin

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous