This case report describes a rare instance of multiple spontaneous coronary artery dissections in a patient treated with tissue plasminogen activator, suggesting an underlying eosinophilic arteritis.
Alerts clinicians to potential hazards of thrombolysis in SCAD; leaves open whether eosinophilic arteritis underlies multiple dissections.
A 43-year-old female received tissue plasminogen activator for an acute antero-apical myocardial infarction. Cardiac catheterization demonstrated three focal dissections involving the left anterior descending and circumflex arteries. She expired unexpectantly after undergoing emergency coronary artery bypass grafting for therapy of an extension of her infarct. To our knowledge, this is the fourth report of multiple spontaneous coronary artery dissections and the second in which tissue plasminogen activator was administered. The histologic findings and their implications are reviewed.
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Burkey et al. (1993) studied this question.
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