Key result
Cutting balloon angioplasty treats SCAD linked to gender-affirming estrogen therapy in a 37-year-old transgender female.
Case Report (n=1)
This is the first reported case of spontaneous coronary artery dissection in a male-to-female transgender patient, highlighting gender-affirming estrogen therapy as a potential risk factor.
Consider SCAD in transgender patients on estrogen with chest pain; single case leaves open any causal link to therapy.
We report the case of a 37-year-old transgender patient with a history of orchiectomy on gender-affirming estrogen therapy who was hospitalized with an acute onset of chest pain with a resolution shortly after the presentation. On presentation, the patient had a rapid rise in troponin level and was urgently taken to the cardiac catheterization lab where spontaneous coronary artery dissection was diagnosed and treated with cutting balloon angioplasty and medical management. After a multidisciplinary discussion, the only notable risk factor was estrogen supplementation after gender reassignment surgery. To our knowledge, this is the only report of a male to female transgender patient reported to have spontaneous coronary artery dissection.
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Hirsch et al. (2022) conducted a case report in Spontaneous coronary artery dissection (n=1). Gender-affirming estrogen therapy was evaluated on Spontaneous coronary artery dissection. A 37-year-old transgender female on gender-affirming estrogen therapy developed spontaneous coronary artery dissection, which was treated with cutting balloon angioplasty and medical management.
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