In a case series of five young South Asian patients with spontaneous coronary artery dissection, conservative medical management provided favorable long-term survival over a mean follow-up of 7 years.
Case Report (n=5)
No
In a small South Asian case series, conservative medical management of spontaneous coronary artery dissection provided favorable long-term survival.
AIM: Spontaneous coronary artery dissection (SCAD) is a less recognized cause of ST elevation myocardial infarction (STEMI) in clinical practice. The aim of this communication is to describe a case series in South Asian population and highlight on the long-term clinical outcomes on conservative management. METHODS: A retrospective analysis of data of five patients (6 instances) of SCAD managed in a tertiary care center during January 1994 to June 2015 was done. Clinical, angiographic, therapeutic, and follow-up data till end of June 2015 are analyzed. RESULTS: All patients were young (mean - 33 years) and predominantly male. Etiology of SCAD was diverse and included peripartum state, vigorous activity and atherosclerosis. Left anterior descending (LAD) coronary artery was predominantly involved and the majority had angiographic type 1 SCAD. Medical treatment provides excellent long-term benefits. Coronary stenting provided symptomatic benefit in a patient with favorable anatomy. CONCLUSIONS: Clinical recognition of SCAD is difficult. It should be suspected in peripartum state, young females and in presence of other precipitating factors. Coronary angiography is essential for establishing the diagnosis. Medical treatment provides favorable long-term survival. IMPLICATIONS AND PRACTICE: The awareness of SCAD is important for all clinicians involved in STEMI care. A prompt suspicion can avoid administration of thrombolytic therapy. Early coronary angiography will provide an accurate diagnosis and help in deciding appropriate therapy. Percutaneous intervention can be challenging.
Sharma et al. (Tue,) conducted a case report in Spontaneous coronary artery dissection (SCAD) (n=5). Conservative medical management was evaluated on Long-term clinical outcomes (survival and recurrence). In a case series of five young South Asian patients with spontaneous coronary artery dissection, conservative medical management provided favorable long-term survival over a mean follow-up of 7 years.