Why the study?
Spontaneous coronary artery dissection is an underdiagnosed and rare cause of myocardial infarction, causing acute coronary syndrome in 1.7% to 4% of cases.
This case highlights the importance of suspecting SCAD in young women presenting with acute MI, screening for associated fibromuscular dysplasia, and considering conservative management.
SCAD may progress rapidly yet heal spontaneously; leaves open optimal timing for intervention or serial imaging.
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an underdiagnosed and rare cause of myocardial infarction (MI). SCAD is defined as the separation of the coronary artery wall by hemorrhage with or without intimal tear. It causes acute coronary syndrome in 1.7% to 4% of cases. CASE SUMMARY: We report a case of a patient with acute MI caused by SCAD with marked progression of dissection within 4 days and spontaneous healing in 2 months. Fibromuscular dysplasia (FMD) of the arteries is an associated condition of SCAD that was found in our patient. CONCLUSION: In young women admitted to the clinic with signs of acute myocardial infarction, SCAD should be suspected. FMD as an associated condition that should be ruled out in every SCAD patient. Conservative treatment of SCAD is the most preferable strategy.
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Kalinskaya et al. (2019) studied this question.
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