Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2011 Mar 3:6:22.
doi: 10.1186/1749-8090-6-22.

Spontaneous coronary artery dissection in a young man - case report

Julia Schmid  1 , Johann Auer
Affiliations
Case Reports

Spontaneous coronary artery dissection in a young man - case report

Julia Schmid et al. J Cardiothorac Surg. .

Abstract

A 31 year old man with a 17-year-history of drug abuse (heroine and cannabis) was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently, a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending (LAD) artery with Thrombolysis In Myocardial Infarction (TIMI) flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Electrocardiogram at admission with poor R-wave progression and non specific repolarization abnormalities.
Figure 2
Figure 2
Transthoracic echocardiography; 4 chamber view reveals left ventricular thrombus.
Figure 3
Figure 3
Coronary angiography in RAO view with dissection of the left anterior descending artery.
Figure 4
Figure 4
Coronary angiography in posterior-anterior view with caudal angulation with dissection of the LAD.
Figure 5
Figure 5
Coronary angiography in LAO view with dissection of the left anterior descending artery.
Figure 6
Figure 6
Coronary angiography in RAO view 5 days after admission with dissection of the LAD.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Butler R, Webster MWI, Davies G, Kerr A, Bass N, Armstrong G, Steward JT, Ruygrok P, Ormiston J. Spontaneous dissection of native coronary arteries. Heart. 2005;91:223–224. doi: 10.1136/hrt.2003.014423. - DOI - PMC - PubMed
    1. Auer J, Punzengruber C, Berent R, Weber T, Lamm G, Hartl P, Eber B. Spontaneous coronary artery dissection involving the left main stem: assessment by intravascular ultrasound. Heart. 2004;90:e39. doi: 10.1136/hrt.2004.035659. - DOI - PMC - PubMed
    1. Hering D, Piper C, Hohmann C, Schultheiss HP, Horstkotte D. Prospective study of the incidence, pathogenesis and therapy of spontaneous, by coronary angiography diagnosed coronary artery dissection. Z Kardiol. 1998;87:961–70. doi: 10.1007/s003920050253. - DOI - PubMed
    1. Jorgensen MB, Aharonian V, Mansukhani P, Mahrer PR. Spontaneous coronary dissection: a cluster of cases with this rare finding. Am Heart J. 1994;127:1382–7. doi: 10.1016/0002-8703(94)90060-4. - DOI - PubMed
    1. Pretty HC. Dissecting aneurysm of coronary artery in a woman aged 42. BMJ. 1931;i:667.

Publication types

Substances