Delayed cardiogenic shock following spontaneous coronary artery dissection in a young, healthy female: a case report

Spontaneous coronary artery dissection (SCAD) is a rare, non-atherosclerotic cause of acute coronary syndrome that predominantly affects young, healthy women without conventional cardiovascular risk factors. Reporting such cases is essential to raise awareness of their variable presentation and diagnostic challenges, particularly when initial findings are unremarkable. We discuss a case of SCAD in a 37-year-old Iranian woman with no prior medical history or cardiovascular risk factors. The patient was initially presented with non-specific symptoms and a normal ECG. Her condition rapidly progressed to cardiogenic shock, complicated by ventricular arrhythmias, necessitating intensive medical management and hemodynamic support. Coronary angiography confirmed SCAD. Following multidisciplinary care, her cardiac function gradually improved, and the patient was discharged with close follow-up. This case highlights the necessity for clinicians to consider SCAD in young female patients presenting with chest pain, even in the absence of classic risk factors or abnormal initial investigations. Early recognition and a multidisciplinary approach are crucial for optimizing outcomes in this rare yet potentially life-threatening condition.