Spontaneous Coronary Artery Dissection Masquerading as Coronary Artery Stenosis in a Young Patient

Autor: Syed Bilal Rizvi, Muhammad Shabbir Rawala, Muhammad Yasin, S. Tahira Shah Naqvi
Rok vydání: 2019
Předmět:
Adult
Male
Cardiac Catheterization
Chest Pain
medicine.medical_specialty
Coronary Vessel Anomalies
medicine.medical_treatment
Myocardial Infarction
Coronary Artery Disease
Anemia
Sickle Cell
Dissection (medical)
030204 cardiovascular system & hematology
Coronary Angiography
Chest pain
Sudden death
Diagnosis
Differential
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Internal medicine
Intravascular ultrasound
medicine
Humans
Vascular Diseases
cardiovascular diseases
Myocardial infarction
Non-ST Elevated Myocardial Infarction
Ultrasonography
Interventional
Cardiac catheterization
medicine.diagnostic_test
business.industry
Dissection
Coronary Stenosis
Articles
General Medicine
Left ventricular thrombus
medicine.disease
Dyspnea
030220 oncology & carcinogenesis
Cardiology
medicine.symptom
business
Zdroj: The American Journal of Case Reports
ISSN: 1941-5923
DOI: 10.12659/ajcr.913522
Popis: Patient: Male, 34 Final Diagnosis: Spontaneous coronary artery dissection Symptoms: Chest pain Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Rare disease Background: Spontaneous coronary artery dissection (SCAD) is primarily found in females. SCAD can have many precipitating factors such as exercise, trauma, pregnancy, drugs, and connective tissue disease. Prognosis is poor for left main stem, left anterior descending (LAD) artery, and multivessel involvement, especially for females. Case Report: We present a case of young African American male with sickle cell disease who presented with chest pain associated with shortness of breath. He was found to have non-ST elevation myocardial infarction (NSTEMI). He was diagnosed with SCAD during catheterization with the help of intravascular ultrasound imaging. Three drug-eluting stents were placed to cover the proximal LAD vessel along its whole length until resolution of the lesion. The patients’ hospital course was complicated by an additional finding of left ventricular thrombus, possibly a complication of NSTEMI, which was treated with anticoagulation to complete resolution. Conclusions: SCAD is fatal, it can proceed to cause myocardial infarction as in this particular patient’s case, and sudden death if not recognized early. It can be missed on angiography alone; further intracoronary imaging such as intravascular ultrasound and optical computed tomography should be used to confirm the diagnosis of SCAD so that early and appropriate treatment can ensue.
Databáze: OpenAIRE
Externí odkaz: