Spontaneous coronary artery dissection: case report and review of literature

Abstract

Spontaneous coronary artery dissection (SCAD) is a deadly cause of myocardial infarction (MI) that mainly affects otherwise healthy, young females. We examine the case of a young female who presented with chest pain. She developed ST elevations in anterolateral leads mimicking ST elevation MI. Cardiac catheterization was done and showed a proximal left anterior descending (LAD) dissection. The patient underwent primary percutaneous transluminal coronary angioplasty with four paclitaxel-eluting coronary stents placed in the LAD. Diagnosis and management of SCAD have remained a challenge and no guidelines have yet been proposed due to the rarity and uncertain etiology of this condition. We review the medical literature on spontaneous coronary artery dissection and discuss its pathogenesis.