Coronary artery stenting for spontaneous coronary artery dissection: a case report and review of the literature

Cathet Cardiovasc Diagn. 1998 Nov;45(3):280-6. doi: 10.1002/(sici)1097-0304(199811)45:3<280::aid-ccd14>3.0.co;2-p.

Abstract

Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndromes. It occurs in three major groups: in young women in the peripartum period, in patients with atherosclerotic disease, and in an idiopathic group. There are a number of associated conditions, but the pathogenesis remains unclear. Diagnosis can only be made at angiography. Treatments include medical therapy, coronary artery bypass grafts, and newer interventional procedures. We report on a case of spontaneous coronary artery dissection involving the left circumflex artery in a young adult male presenting with a myocardial infarction after exercise. There were no risk factors for coronary artery disease and no evidence of atherosclerosis on angiography. The dissection was treated with primary coronary artery stenting without predilation, achieving an excellent result. To our knowledge, this is the third known case of successful coronary artery stenting for this condition and the first case of primary stenting without prior angioplasty.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aneurysm, Dissecting / complications
  • Aneurysm, Dissecting / diagnostic imaging
  • Aneurysm, Dissecting / surgery*
  • Baseball
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Cardiac Catheterization
  • Coronary Aneurysm / complications
  • Coronary Aneurysm / diagnostic imaging
  • Coronary Aneurysm / surgery*
  • Coronary Angiography
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / etiology
  • Rupture, Spontaneous
  • Stents*