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Case Reports
. 2019 Aug 29;1(3):e190035.
doi: 10.1148/ryct.2019190035. eCollection 2019 Aug.

Coronary Artery Involvement in Segmental Arterial Mediolysis: A Case Report

Michael A Winkler  1 , Harit Kapoor  1 , Ahmad Ramy Elashery  1 , Mohamed Issa  1 , Driss Raissi  1 , Vedant Gupta  1 , Mary Sheppard  1
Affiliations
Case Reports

Coronary Artery Involvement in Segmental Arterial Mediolysis: A Case Report

Michael A Winkler et al. Radiol Cardiothorac Imaging. .

Abstract

Segmental arterial mediolysis (SAM) is an increasingly recognized disorder affecting small- to medium-sized muscular arteries. A patient with SAM involving the visceral arteries who was also found to have multivessel coronary artery involvement is described. The patient underwent a battery of biochemical, imaging, and genetic tests to exclude other vasculitides and connective tissue disorders. The aim is to shed light on the potential for SAM to affect the coronary arteries and recommend screening of the coronary arteries of patients with SAM. © RSNA, 2019.

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Conflict of interest statement

Disclosures of Conflicts of Interest: M.A.W. disclosed no relevant relationships. H.K. disclosed no relevant relationships. A.R.E. disclosed no relevant relationships. M.I. disclosed no relevant relationships. D.R. disclosed no relevant relationships. V.G. disclosed no relevant relationships. M.S. disclosed no relevant relationships.

Figures

Figure 1:
Figure 1:
(Left) Anterior and (right) lateral projection curved planar reformat images of the superior mesenteric artery (*) demonstrate chronic aneurysm, dissection, and thrombus. A = aorta.
Figure 2:
Figure 2:
Pseudocolored multimasked volume rendering of the aortic root and coronary arteries. The black asterisk demarks an aneurysm and dissection of the left circumflex coronary artery. Other aneurysms and dissections of the coronary arteries can be seen.
Figure 3:
Figure 3:
Curved planar reformat image of the left circumflex coronary artery. The black asterisk demarks the aneurysm and dissection present.
Figure 4:
Figure 4:
Differences between segmental arterial mediolysis (SAM) versus fibromuscular dysplasia (FMD). Diagnosis of either of these uncommon medium-vessel vasculopathies requires exclusion of other pathologic conditions (eg, collagen vascular diseases).
Figure 5:
Figure 5:
Schematic representation of pathologic association between fibromuscular dysplasia, spontaneous coronary artery dissection, and segmental arterial mediolysis.
See this image and copyright information in PMC

References

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