Key result
Conservative medical management with dual antiplatelet therapy and beta-blockers guided by optical coherence tomography resulted in complete resolution of the coronary artery aneurysm and healing of the dissection.
Why the study?
SCAD complicated by coronary artery aneurysm is rare and seldom reported, and an obscure intimal flap may not be recognized with conventional coronary angiography alone.
Case Report (n=1)
Conservative medical management guided by optical coherence tomography can lead to complete healing of pregnancy-related SCAD complicated by a coronary artery pseudoaneurysm.
Answers are grounded in this paper and cite their sources.
May support OCT-guided conservative management in pregnancy-related SCAD with pseudoaneurysm; hypothesis-generating and should not yet change practice.
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial ischemia. SCAD complicated by coronary artery aneurysm (CAA) is rare and seldom reported. Coronary angiography is the gold standard for the diagnosis of SCAD. However, an obscure intimal flap may not be recognized with a conventional coronary angiogram, and intravascular imaging modalities are important in the diagnosis of SCAD. Optical coherence tomography contributes to providing information about the size, shape, and location of CAAs. Herein, we are presenting a challenging and unique case of a woman presenting with SCAD complicated by a CAA.
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Subbramaniyam et al. (2022) conducted a case report in Spontaneous coronary artery dissection (SCAD) complicated by coronary artery aneurysm (CAA) (n=1). Conservative medical management (dual antiplatelet therapy and beta-blockers) guided by OCT was evaluated on Resolution of hematoma and aneurysm. Conservative medical management with dual antiplatelet therapy and beta-blockers guided by optical coherence tomography resulted in complete resolution of the coronary artery aneurysm and healing of the dissection.
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