Spontaneous coronary dissection presenting with reperfusion arrhythmia: A case report
| Autor: | Nosheen Sarwar, Muhammad Rizwan Sardar, Frank C. McGeehin, Ghazi Mirrani, Wajeeha Saeed, Khawar Maqsood, Paul Coady, Joseph Kusick, James F. Burke, Marwan Badri |
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| Rok vydání: | 2013 |
| Předmět: |
Acute coronary syndrome
medicine.medical_specialty Accelerated idioventricular rhythm Unstable angina business.industry medicine.medical_treatment Percutaneous coronary intervention General Medicine Dissection (medical) medicine.disease Internal medicine medicine Palpitations Eptifibatide Cardiology medicine.symptom business medicine.drug Metoprolol |
| Zdroj: | Case Reports in Clinical Medicine. :215-218 |
| ISSN: | 2325-7083 2325-7075 |
| DOI: | 10.4236/crcm.2013.23058 |
| Popis: | Spontaneous coronary dissection is more commonly reported in females and is an important differential diagnosis for acute coronary syndrome. Accelerated idioventricular rhythm has been reported before with reperfusion post myocardial ischemia. We report a case of accelerated idioventricular rhythm in a patient with spontaneous coronary artery dissection. A 45-year-old Caucasian female presented with left sided chest pain radiating to the neck and palpitations. Admission ECG showed accelerated idioventricular rhythm. Troponin I peaked at 0.5 ng/ml. Coronary angiography showed mid to distal left anterior descending artery dissection with adequate distal flow. Patient was initially medically managed with aspirin, metoprolol, intravenous heparin and eptifibatide infusions but continued to have symptoms of unstable angina. She underwent successful percutaneous coronary intervention with 2 drug eluting stents and was discharged back home symptom free on dual platelet therapy. Spontaneous coronary artery dissection is an important differential diagnosis for acute coronary syndrome especially in younger females. Accelerated idioventricular rhythm can be a presentation of coronary dissection and may indicate instability. Early percutaneous coronary intervention should be considered in such patients. |
| Databáze: | OpenAIRE |
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