Key result
Conservative management with dual-antiplatelet therapy followed by single antiplatelet therapy resulted in the complete angiographic resolution of type 2A spontaneous coronary artery dissection after 8 months.
Case Report (n=1)
This case report demonstrates the successful conservative management of type 2A SCAD using dual antiplatelet therapy followed by single antiplatelet therapy, resulting in angiographic resolution at 8 months.
Novel SCAD case in atypical patient warrants diagnostic vigilance; leaves open questions on prevalence, mechanisms, and management.
Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic separation of the coronary artery wall with subsequent intramural hematoma (IMH) formation in the false lumen. It can be associated with or without an intimal tear. It is clinically divided into three types based on its angiographic appearance. Most SCAD cases are seen in young or middle-aged women, especially in a peripartum state. Additionally, SCAD patients usually have fewer cardiovascular risk factors and more commonly have predisposing conditions like fibromuscular dysplasia (FMD). Patients present with features of chest pain that radiates to the left arm or neck, shortness of breath (SOB), as well as nausea and vomiting. Coronary angiography is the most widely used first-line modality to diagnose this condition. Management is usually conservative; however, invasive procedures can be utilized for high-risk patients. We present a case of a 54-year-old woman with SCAD diagnosed using coronary angiography and treated conservatively with dual-antiplatelet therapy, culminating with resolution.
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Khudair et al. (2023) conducted a case report in Spontaneous Coronary Artery Dissection (SCAD) (n=1). Conservative management (Dual-antiplatelet therapy) was evaluated on Resolution of SCAD on follow-up CT coronary angiography. Conservative management with dual-antiplatelet therapy followed by single antiplatelet therapy resulted in the complete angiographic resolution of type 2A spontaneous coronary artery dissection after 8 months.
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