Successful Treatment of Spontaneous Coronary Artery Dissection With Cutting Balloon Angioplasty

Mohamed Zghouzi,M Chadi Alraies,Homam Moussa Pacha,Yasar Sattar

doi:10.7759/cureus.13706

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare but serious condition that requires immediate attention. It has a similar presentation to acute coronary syndrome in terms of chest pain, electrocardiogram changes, and an increase in troponins, and is considered to be a significant cause of myocardial infarction. Coronary angiography is needed to confirm the diagnosis, and subsequent repair should be pursued when needed. We describe a case of SCAD in a 72-year-old female treated using the cutting balloon angioplasty technique to create communication between the true and false lumens.

Highlights

Spontaneous coronary artery dissection (SCAD) is a rare but serious condition that requires immediate attention
It has a similar presentation to acute coronary syndrome in terms of chest pain, electrocardiogram changes, and an increase in troponins, and is considered to be a significant cause of myocardial infarction
We describe a case of SCAD in a 72-year-old female treated using the cutting balloon angioplasty technique to create communication between the true and false lumens

Summary

Introduction

Spontaneous coronary artery dissection (SCAD) is a rare but serious condition that requires immediate attention. The current recommendation is to refrain from coronary stenting, especially if the coronary flow is preserved In this case, we present a patient with ACS who was found with coronary dissection and treated with cutting balloon angioplasty alone. A 72-year-old female with a medical history of hypertension, paroxysmal atrial fibrillation, type B thoracic aortic dissection status, post-percutaneous endovascular repair, stenting gastroepiploic artery aneurysm status post coil embolization, and mitral valve prolapse presented with chest pain. She described the chest pain as heavy and centrally located. Complete occlusion of the mid-section of the left anterior descending (LAD) artery and Thrombolysis in Myocardial Infarction (TIMI) flow score of 0-1 due to spontaneous coronary artery dissection (Figure 2A) were noted. CTA, computed tomography angiography; LAD, left anterior descending; LCX, left circumflex artery; RCA, right coronary artery

Discussion

Disclosures