Highlights a rare presentation of fatal spontaneous coronary artery dissection involving the distal obtuse marginal branch in a middle-aged man.
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May inform sudden death differentials in middle-aged adults; leaves open true incidence of distal SCAD variants.
Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction and sudden death. It typically, but not always, occurs in healthy postpartum women without traditional risk factors for atherosclerosis. Moreover, the site of dissection usually involves the proximal, major coronary arteries: left main coronary artery and/or the left anterior descending artery, and in men, more often the right coronary artery. We report a case of sudden death caused by dissection of the obtuse marginal branch of the left circumflex artery, in a 49-year-old man, a very rare site of fatal coronary dissection.
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Wei et al. (2008) studied this question.
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