Key result
IV thrombolytics and anticoagulation resolve thrombus but spiral dissection persists in a SCAD case.
Case Report (n=1)
This case report highlights the utility of intracoronary ultrasound in confirming persistent spiral dissection after thrombus resolution in spontaneous coronary arterial dissection.
May support thrombolysis plus short anticoagulation for thrombus in SCAD; leaves open the role of intracoronary imaging to detect persistent dissection.
We report the case of a middle-aged female who presented with an acute inferior myocardial infarction treated with intravenous thrombolytics. Immediate coronary angiography demonstrated the presence of a spiral dissection and a large thrombus. After 1 week of anticoagulation the thrombus had resolved, but a large spiral dissection persisted. This was confirmed by intracoronary ultrasound. We then review the literature on spontaneous coronary arterial dissection.
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Carell et al. (1994) conducted a case report in Acute myocardial infarction due to spontaneous coronary arterial dissection (n=1). Intravenous thrombolytics and anticoagulation was evaluated. Treatment with intravenous thrombolytics and 1 week of anticoagulation resolved the thrombus in a patient with spontaneous coronary arterial dissection, but the spiral dissection persisted.
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