Conservative medical treatment in a 56-year-old woman with SCAD presenting as STEMI resulted in a perfused coronary artery at 6 weeks follow-up.
Case Report (n=1)
Does conservative medical treatment lead to angiographic healing in a patient with spontaneous coronary artery dissection?
This case report illustrates that conservative medical management can be effective for spontaneous coronary artery dissection, leading to angiographic healing at 6 weeks.
Spontaneous coronary artery dissection (SCAD) is often revealed by an acute coronary syndrome classified then as a MINOCA. The typical patient is a female patient with no or few cardiovascular risk factor. Our work aims to illustrate the effectiveness of medical treatment in patients with SCAD. Case Report: We report a case of a 56-year-old female patient who was admitted after 3 days of infarct-like thoracic pain related to an anterior extended ST-elevation myocardial infarction. The coronarography showed a SCAD of the left anterior descending coronary artery. The patient was discharged under medical treatment. Six weeks later, coronarography showed a perfused coronary artery. Discussion: Most cases of SCAD present as acute coronary syndrome. Coronary angiography remains the 'first-line' examination. The use of endocoronary imaging such as IVUS and optical coherence tomography is necessary in case of diagnostic doubt (especially in SCAD type 2 and 3). The optimal management of SCAD remains unclear. A conservative approach should be the preferred strategy. Conclusion: SCAD should be considered in any young woman presenting with suspicious chest pain with positive troponin. The diagnosis is initially angiographic and may require endocoronary imaging for greater accuracy. Conservative treatment remains the best option.
Britel et al. (Sun,) conducted a case report in Spontaneous coronary artery dissection (SCAD) (n=1). Medical treatment was evaluated on Coronary artery perfusion. Conservative medical treatment in a 56-year-old woman with SCAD presenting as STEMI resulted in a perfused coronary artery at 6 weeks follow-up.