Abstract
Spontaneous coronary artery dissection (SCAD) should be strongly suspected in young women with few or no traditional risk factors for atherosclerosis. Prompt diagnosis and treatment improve survival. The most appropriate strategy for managing SCAD is still controversial due to the heterogeneity of this population. We describe a case of spontaneous left main coronary artery (LMCA) dissection in a young women that was successfully managed by percutaneous coronary intervention (PCI) followed by coronary artery bypass grafting (CABG), this case illustrates the utility of coronary computed tomography (CT) and magnetic resonance imagery (MRI) in assessing complex coronary dissection, thereby helping to determine the best timing for surgery.
Highlights
Coronary artery dissection is termed spontaneous upon exclusion of secondary causes such as cardiac catherization, chest trauma, aortic root dissection and cardiac surgery
We describe a case of spontaneous left main coronary artery (LMCA) dissection in a young women that was successfully managed by percutaneous coronary intervention (PCI) followed by coronary artery bypass grafting (CABG), this case illustrates the utility of coronary computed tomography (CT) and magnetic resonance imagery (MRI) in assessing complex coronary dissection, thereby helping to determine the best timing for surgery
We present a case of young women who presented with an acute coronary syndrome (ACS) due to an occlusive Spontaneous coronary artery dissection (SCAD) involving left main stem
Summary
Coronary artery dissection is termed spontaneous upon exclusion of secondary causes such as cardiac catherization, chest trauma, aortic root dissection and cardiac surgery. The diagnosis is usually made by urgent coronary angiography. Therapeutic options include medical therapy, PCI and surgery. On the coronary vessels or in other vascular bed, extended follow-up should be considered. We present a case of young women who presented with an acute coronary syndrome (ACS) due to an occlusive SCAD involving left main stem. CT coronary angiography and cardiac MRI were used to document the persistence of the dissection and to guide the decision to proceed with surgical revascularisation
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