Key result
Intravascular ultrasound identified spontaneous coronary artery dissection in a 46-year-old female with ADPKD and ACS after coronary angiography showed no definite signs of dissection.
Case Report (n=1)
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In patients with ADPKD presenting with ACS, SCAD should be highly suspected and IVUS utilized if coronary angiography is inconclusive.
BACKGROUND: When autosomal dominant polycystic kidney disease (ADPKD) presents with acute coronary syndrome (ACS), the possibility of spontaneous coronary artery dissection (SCAD) should be highly considered. In some cases, SCAD is considered an extrarenal manifestation of ADPKD depending on the pathological characteristics of the unstable arterial wall in ADPKD. CASE SUMMARY: Here, we report a 46-year-old female patient with ADPKD who presented with ACS. Coronary angiography revealed no definite signs of dissection, while intravascular ultrasound revealed a proximal to distal dissection of the left circumflex. After a careful conservative medication treatment, the patient exhibited favorable prognosis. CONCLUSION: In cases of ADPKD co-existing with ACS, differential diagnosis of SCAD should be considered. Moreover, when no clear dissection is found on coronary angiography, IVUS should be performed to prevent missed diagnosis.
Qian et al. (2021) conducted a case report in Autosomal dominant polycystic kidney disease (ADPKD) with acute coronary syndrome (ACS) (n=1). Intravascular ultrasound (IVUS) was evaluated on Detection of spontaneous coronary artery dissection (SCAD). Intravascular ultrasound identified spontaneous coronary artery dissection in a 46-year-old female with ADPKD and ACS after coronary angiography showed no definite signs of dissection.
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