A 38-year-old woman with ADPKD and acute myocardial infarction was successfully treated for spontaneous coronary artery dissection using drug-eluting stents, suggesting ADPKD as a predisposing factor.
Case Report (n=1)
No
Autosomal dominant polycystic kidney disease may be a predisposing factor for spontaneous coronary artery dissection, which should be considered in young patients with myocardial infarction lacking traditional atherosclerotic risk factors.
Abstract Autosomal dominant polycystic kidney disease (ADPKD) may present with a variety of extrarenal manifestations. Only 1 case of spontaneous coronary artery dissection has been reported so far in ADPKD. Here we report a case of coronary artery dissection occurring in a 38-year-old woman with ADPKD and an unremarkable medical history. She was admitted to the intensive care unit with acute chest pain. Anterior myocardial infarction was diagnosed by ECG; the patient was treated with thrombolysis with tenecteplase and aspirin, heparin and carvedilol. Then she was referred to the cardiac catheterization laboratory. Coronary angiography revealed a long linear dissection in the middle left descending coronary artery (DCA) with TIMI 1 distal flow. Complete vessel recanalization was achieved by positioning 2 drug-eluting and overlapped stents in the middle DCA and a further proximal stent due to residual proximal dissection, resulting in a TIMI 3 distal flow. There were no procedural complications, and the patient was discharged on day 8. In conclusion, spontaneous coronary artery dissection is a rare cause of myocardial ischemia and infarction. Myocardial infarction in patients without any risk factors for coronary atherosclerosis or in young patients should prompt a diligent search for a possible spontaneous coronary artery dissection. It is suggested that ADPKD may be a predisposing factor for spontaneous coronary artery dissection.
Basile et al. (Fri,) conducted a case report in Spontaneous coronary artery dissection and Autosomal dominant polycystic kidney disease (n=1). Thrombolysis and percutaneous coronary intervention with drug-eluting stents was evaluated. A 38-year-old woman with ADPKD and acute myocardial infarction was successfully treated for spontaneous coronary artery dissection using drug-eluting stents, suggesting ADPKD as a predisposing factor.