Spontaneous coronary artery dissection: a case series and literature review

Journal of Community Hospital Internal Medicine Perspectives

Nelson A. Telles Garcia¹  Ratna C. Boppana¹  Abul N. Khan²  Hayden L. Smith³ 

[1] Internal Medicine Resident PGY-3, The University of Iowa – Des Moines Internal Medicine Residency Program, IA, USA;The University of Iowa – Des Moines Internal Medicine Residency Program, IA, USA;UnityPoint Health, Des Moines, IA, USA;

关键词: spontaneous coronary artery dissection;    coronary angiography;    optical coherence tomography;    intravascular ultrasound;    myocardial infarction;    angina;   

DOI  :  10.3402/jchimp.v4.25261

来源: DOAJ

【 摘 要 】

Spontaneous coronary artery dissection (SCAD) is a rare and often lethal cause of acute coronary syndrome, which typically affects young women and otherwise healthy individuals. SCAD can be diagnosed in patients undergoing coronary angiography and can be underestimated. Special techniques such as optical coherence tomography (OCT) and intravascular ultrasound should be used when there is suspicion of the condition. In the majority of cases, the left anterior descending (LAD) artery is involved; however, a few cases of the right coronary artery (RCA) involvement have been reported. This article describes three cases of SCAD in women of different ages, all presenting with chest pain. Coronary angiography in conjunction with OCT was used for diagnosis in two of the cases. One of the patients had involvement of the proximal RCA and underwent percutaneous coronary intervention, whereas the other two patients had mid-LAD disease and were treated conservatively with medical therapy. Presently, there are no specific guidelines for the treatment of SCAD, and therapy is individualized according to extent and severity of the condition.

【 授权许可】

Unknown