Key result
Antiplatelet and anticoagulation therapy successfully manages SCAD complicated by LV thrombus in a young female.
Case Report (n=1)
No
This case highlights the importance of considering spontaneous coronary artery dissection in young women presenting with ACS, where standard thrombolysis may be harmful, and documents a rare complication of left ventricular thrombus.
May support conservative antithrombotic management in select SCAD cases with LV thrombus; leaves open optimal regimens and generalizability.
Spontaneous Coronary Artery Dissection (SCAD) is a non-atherosclerotic, non-iatrogenic cause of Acute Coronary Syndrome (ACS) resulting in a tear in the coronary artery wall with subsequent myocardial infarction. Though rare, it has been increasingly recognized, especially in young women. This is a case report on SCAD where, fortuitously, the patient did not receive standard tissue plasminogen activator (TPA) on presentation of suspected ST-elevation Myocardial Infarction (STEMI). Subsequent investigations revealed a left ventricular thrombus on echocardiogram and SCAD on coronary angiogram.
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Ramrattan et al. (2023) conducted a case report in Spontaneous Coronary Artery Dissection (SCAD) with Left Ventricular Thrombus (n=1). Conservative medical management (antiplatelets and anticoagulation) was evaluated. Conservative medical therapy including antiplatelets and anticoagulation successfully managed a 31-year-old female with spontaneous coronary artery dissection and a left ventricular thrombus.
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