Concomitant coronary microvascular dysfunction and spontaneous coronary artery dissection resulting in ST-segment elevation myocardial infarction

Eldon Matthia; Carl J Pepine; Ellen C Keeley

doi:10.1016/j.jccase.2021.06.014

Concomitant coronary microvascular dysfunction and spontaneous coronary artery dissection resulting in ST-segment elevation myocardial infarction

J Cardiol Cases. 2021 Jul 22;25(2):76-78. doi: 10.1016/j.jccase.2021.06.014. eCollection 2022 Feb.

Authors

Eldon Matthia¹, Carl J Pepine², Ellen C Keeley²

Affiliations

¹ Department of Medicine, University of Florida, Gainesville, FL, USA.
² Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA.

Abstract

We report a patient with angina and no flow-limiting epicardial coronary artery disease who presented with recurrent spontaneous coronary artery dissection resulting in an acute ST-elevation myocardial infarction and evidence of coronary microvascular dysfunction on coronary angiography. We review each condition's pathophysiology and provide a review of the literature for reported associations between these disease processes. <Learning objective: Readers will recognize the considerable overlap of risk factors between patients with spontaneous coronary artery dissection and coronary microvascular dysfunction. Our patient had both conditions underlying her heart disease. We provide a review of the literature regarding the underlying pathophysiology for each condition and underscore possible associations between these disease processes. Further studies are needed to determine a definitive link.>.

Keywords: Coronary microvascular dysfunction; ST-elevation myocardial infarction; Spontaneous coronary artery dissection.

Publication types

Case Reports