American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2020, 8(9), 274-276
DOI: 10.12691/ajmcr-8-9-5
Open AccessCase Report

Spontaneous Coronary Artery Dissection Treated Conservatively in a Non-pregnant Patient: A Case Report

Jonathan Francois1, Sostanie Takota Enoru1, Joseph Casillas1, Dommalur Jayaranagaiah2, Pramod Theetha Kariyanna1, Ishmam Ibtida1, Moro O. Salifu1 and Samy I. McFarlane1,

1Department of Internal Medicine, SUNY-Downstate-Health Science University, Brooklyn, New York, United States- 11203

2Department of Medicine, Milton Cato Memorial Hospital, Kingstown, Saint Vincent and the Grenadines, VC0130

Pub. Date: May 29, 2020

Cite this paper:
Jonathan Francois, Sostanie Takota Enoru, Joseph Casillas, Dommalur Jayaranagaiah, Pramod Theetha Kariyanna, Ishmam Ibtida, Moro O. Salifu and Samy I. McFarlane. Spontaneous Coronary Artery Dissection Treated Conservatively in a Non-pregnant Patient: A Case Report. American Journal of Medical Case Reports. 2020; 8(9):274-276. doi: 10.12691/ajmcr-8-9-5


Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction (MI) and it is greatly misdiagnosed. If not recognized, SCAD carries a high in-hospital mortality rate. It is most commonly seen in females during the peripartum period, individuals with atherosclerotic disease and/or connective tissue disorders. In this report we present a case of 55 years old non-pregnant female without history coronary artery disease (CAD), who presented with squeezing chest pain, ST segment elevation on electrocardiogram (ECG) and negative cardiac markers. Subsequently coronary angiogram (CAG) revealed dissection of the left anterior descending artery (LAD) with 100% stenosis. Due to high risk of perforation it was decided to treat the patient conservatively and subsequently she was discharged home with no complications. In this report, we demonstrated that early recognition of SCAD and conservative management, in a non-pregnant patient, can lead to decreases in-hospital complications and favorable outcomes.

spontaneous coronary dissection acute coronary syndrome non-pregnant female

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[1]  Taha M, Latt H, Al-Khafaji J, Ali M, Seher R. A case of spontaneous coronary artery dissection presenting with acute anterior wall myocardial infarction in a young adult male - an increasingly recognized rare disease. J Community Hosp Intern Med Perspect. 2018; 8(2): 60-63. Published 2018 Apr 17.
[2]  Lebrun, S., & Bond, R. M. (2018). Spontaneous coronary artery dissection (SCAD): The underdiagnosed cardiac condition that plagues women. Trends in Cardiovascular Medicine, 28(5), 340-345.
[3]  Rashid HN, Wong DT, Wijesekera H, Gutman SJ, Shanmugam VB, Gulati R, et al. Incidence and characterisation of spontaneous coronary artery dissection as a cause of acute coronary syndrome—a single-centre Australian experience. Int J Cardiol 2016; 202: 336-8.
[4]  Nishiguchi T, Tanaka A, Ozaki Y, Taruya A, Fukuda S, Taguchi H, et al. Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome. Eur Heart J Acute Cardiovasc Care 2016; 5: 263-70.
[5]  Hill SF, Sheppard MN. Non-atherosclerotic coronary artery disease associated with sudden cardiac death. Heart 2010; 96: 1119-25.
[6]  Pretty H. Dissecting aneurysm of coronary artery in a woman aged 42. Br Med J 1931; 1: 667.
[7]  Tweet MS, Kok SN, Hayes SN. Spontaneous coronary artery dissection in women: What is known and what is yet to be understood. Clin Cardiol. 2018; 41(2): 203-210.
[8]  Hayes SN, Kim ESH, Saw J, Adlam D, Arslanian-Engoren C, Economy KE, Ganesh SK, Gulati R, Lindsay ME, Mieres JH, Naderi S, Shah S, Thaler DE, Tweet MS, Wood MJ.; American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; Stroke Council. Spontaneous coronary artery dissection: current state of the science: a scientific statement from the American Heart Association. Circulation 2018; 137: e523-e557.
[9]  Spontaneous coronary artery dissection: new insights from the tip of the iceberg? Alfonso F. Circulation. 2012; 126: 667.
[10]  A case report of spontaneous coronary artery dissection and the role of intravascular imaging for accurate diagnosis and successful management. Chen CC, Liu JC, Sung LC, et al. Medicine (Baltimore) 2019; 98: 14112.
[11]  Shamloo BK, Chintala RS, Nasur A, et al. Spontaneous coronary artery dissection: aggressive vs. conservative therapy. J Invasive Cardiol 2010; 22: 222-8.
[12]  Jinnouchi H, Sakakura K, Matsuda J, Wakabayashi Y, Wada H, Momomura S, et al. Recurrent spontaneous coronary artery dissection observed with multiple imaging modalities. Int Heart J 2013; 54: 182-3.