Key result
Conservative management with low-pressure POBA successfully treats stress-induced SCAD in a young woman.
Why the study?
Spontaneous coronary artery dissection (SCAD) is a very rare disease with poorly understood etiology and pathogenesis, and its sporadic nature and varied angiographic extent complicate firm revascularization recommendations.
Case Report (n=1)
This case report highlights the potential role of intense psychological stress in the etiology of spontaneous coronary artery dissection (SCAD) in young, otherwise healthy women, and describes a management strategy utilizing POBA and medical therapy.
May support conservative POBA in select SCAD; hypothesis-generating for stress triggers, larger studies needed before practice change.
Spontaneous coronary artery dissection (SCAD) is a very rare disease, associated with high mortality rate, whose etiology and pathogenesis are poorly understood. Its sporadic nature and the varied angiographic extent make firm recommendations regarding revascularization impossible. The case described is that of a young, otherwise healthy woman, without a known underlying condition which may lead to SCAD, but with a history of intense psychological stress. We managed the patient with a conservative approach based on watchful waiting, medical therapy, and plain old balloon angioplasty (POBA) with low inflation atmospheres.
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Arrivi et al. (2012) conducted a case report in Spontaneous coronary artery dissection (SCAD) (n=1). Conservative approach (watchful waiting, medical therapy, and POBA) was evaluated. A young woman with spontaneous coronary artery dissection and intense psychological stress was managed with a conservative approach including watchful waiting, medical therapy, and POBA.
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