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Case Reports
. 2019 May 31;2019(5):omz033.
doi: 10.1093/omcr/omz033. eCollection 2019 May.

Spontaneous coronary artery dissection in cardiac sarcoidosis

Riina Kandolin  1 , Kaj Ekström  2 , Trevor Simard  1 , Benjamin Hibbert  1 , Pablo Nery  1 , Jukka Lehtonen  2 , Markku Kupari  2 , David Birnie  1
Affiliations
Case Reports

Spontaneous coronary artery dissection in cardiac sarcoidosis

Riina Kandolin et al. Oxf Med Case Reports. .

Abstract

Cardiac sarcoidosis (CS) is increasingly recognized as a cause of diverse cardiac manifestations. Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome especially among young females. The prevalence of sarcoidosis in the causal spectrum of SCAD has not been described before but sarcoidosis is cited as a potential yet rare cause of SCAD. We aimed to examine the frequency and characteristics of SCAD in CS. Searching two prospective CS registries with 481 CS patients, we found only one case of manifest SCAD. She is a 61-year-old female previously diagnosed with endomyocardial biopsy confirmed CS. She presented with chest pain and elevated troponin. Coronary angiogram revealed two-vessel SCAD. Fluorodeoxyglucose positron emission tomography scan showed likely reactivation of CS. The patient was treated with dual antiplatelet therapy and immunosuppression. Repeat angiogram showed complete resolution of the coronary lesions.

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Figures

Figure 1
Figure 1
Whole body FDG-PET images (upper panels) and 4HC transaxial views of fused FDG-PET/CT thorax images (lower panels). Scan 1A upper panel: no cardiac or mediastinal FDG uptake. Scan 1A lower panel: no FDG uptake. Scan 1B upper panel: increased FDG uptake in mediastinal and hilar lymph nodes, basal to mid inferior wall and basal to mid anterior wall. Scan 1B lower panel: increased FDG uptake in the basal to mid inferior septum and lateral wall.
Figure 2
Figure 2
(A) Showing mural dye hung-up in the distal LCX due to mural hematoma. (B) Showing complete resolution of the LCX lesion.
See this image and copyright information in PMC

References

    1. Hayes S, Kim E, Saw J, Adlam D, Arslanian-Engoren C, Economy K, et al. Spontaneous coronary artery dissection: current state of the science: a scientific statement from the American Heart Association. Circulation 2018;137:1–66. - PMC - PubMed
    1. Adlam D, Alfonso F, Maas A, Vrints C, Writing Committee . European Society of Cardiology, acute cardiovascular care association, SCAD study group: a position paper on spontaneous coronary artery dissection. Eur Heart J 2018;39:3353–3368. - PMC - PubMed
    1. Garg J, Krishnamoorthy P, Palaniswamy C, Pandey A, Ahmad H. Predictors of in-hospital mortality in coronary artery dissection: findings from the National Inpatient Sample 2009–2010. Cardiol J 2015;22:135–140. - PubMed
    1. Ehya H, Weitznes S. Postpartum dissecting aneurysm of coronary arteries in a patient with sarcoidosis. South Med J 1980;73:87–88. - PubMed
    1. Kanaraglou S, Nair V, Fernandes JR. Sudden cardiac death due to coronary artery dissection as a complication of cardiac sarcoidosis. Cardiovasc Pathol 2015;24:244–246. - PubMed

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