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Case Reports
. 2024 Jan 17;19(4):1457-1462.
doi: 10.1016/j.radcr.2023.12.048. eCollection 2024 Apr.

Spontaneous coronary dissection: A rare etiology of acute coronary syndrome

Zakaria El Marraki  1 , Karim Mounaouir  2 , Pierre Marcolet  1 , Nassim Halet  1 , Valerian Didot  1 , Thierry Dechery  1
Affiliations
Case Reports

Spontaneous coronary dissection: A rare etiology of acute coronary syndrome

Zakaria El Marraki et al. Radiol Case Rep. .

Abstract

Spontaneous coronary artery dissection is a rare etiology of acute coronary syndrome and falls into the category of myocardial infarction with no obstructive coronary arteries. It occurs mainly in young women with no cardiovascular risk factors. Diagnosis is often made by coronary angiography and sometimes by endocoronary imaging. the association of coronary dissection and ACS is rare, especially in men. The management is poorly codified and depends mainly on the habits of the practitioner, and may be medical, percutaneous or surgical. the outcome is often favorable, but sometimes there is a risk of recurrence with a guarded prognosis. In this context, we report the case of a 43-year-old patient with antecedent spontaneous coronary dissection, admitted to our unit for the management of acute coronary syndrome following recurrent coronary dissection.

Keywords: Acute coronary syndrome, Case report; Spontaneous coronary dissection.

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Figures

Fig 1
Fig. 1
Coronary angiography showing type B dissection of the distal anterior interventricular retroventricular artery.
Fig 2
Fig. 2
Resting sinus ECG at 72 beats/min with no repolarization disorder.
Fig 3
Fig. 3
(A and B) Coronary angiography showing type B dissection of the posterior retroventricular artery.
Fig. 4
Fig. 4
Cross-sectional views of the coronary artery. (A) Normal coronary artery. (B) Coronary artery with intramural hematoma and (C) Coronary artery with intimal tear.
Fig. 5
Fig. 5
Algorithm for diagnosis of spontaneous coronary artery dissection (SCAD) in the setting of acute coronary syndrome. CT indicates computed tomography; CTA, computed tomography angiography; FMD, fibromuscular dysplasia; IC, intracoronary; IVUS, intravascular ultrasonography; MRA, magnetic resonance angiography; and OCT, optical coherence tomography .
Fig. 6
Fig. 6
Algorithm for management of acute spontaneous coronary artery dissection. CABG, coronary artery bypass grafting; PCI, percutaneous coronary intervention; Rx, management. aLeft main or proximal 2-vessel coronary artery dissection .
See this image and copyright information in PMC

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