Targeted drug-eluting stent implantation and conservative management in a male patient with multivessel SCAD resulted in complete spontaneous healing of all lesions with no recurrence at 6 months.
Case Report (n=1)
Multivessel SCAD can present in various forms and may heal spontaneously, suggesting conservative management can be effective even when lesions progress asymptomatically.
Spontaneous coronary artery dissection (SCAD) is a rare condition that may have a serious outcome because of acute coronary syndrome. The condition especially affects young women. We evaluated a middle-aged male patient with a non-ST segment elevation myocardial infarction caused by multivessel SCAD. The SCAD had occurred in the distal right coronary artery (RCA), the mid left anterior descending artery (LAD), and the distal LAD at the same time. His culprit lesion was in the distal RCA, but the SCAD had progressed more proximally within the RCA 12 days later with no clinical symptoms. We treated the mid LAD with implantation of a drug-eluting stent on admission and the SCAD had not progressed 12 days later. Moreover, the SCAD in the distal RCA and distal LAD healed spontaneously 12 days later. He had no recurrent attack, and all SCAD lesions of the RCA and LAD had completely healed 6 months later. Given that SCAD appears in various forms over the clinical course, a strategy of intervention needs careful consideration.
Haraki et al. (Fri,) conducted a case report in Spontaneous coronary artery dissection (SCAD) (n=1). Drug-eluting stent implantation and conservative management was evaluated. Targeted drug-eluting stent implantation and conservative management in a male patient with multivessel SCAD resulted in complete spontaneous healing of all lesions with no recurrence at 6 months.