Treatment strategy of spontaneous coronary artery dissection: Conservative or interventional

Spontaneous Coronary Artery Dissection in the Postoperative Period: A Case Report

Spontaneous coronary artery disease is an uncommon and likely underdiagnosed cause of sudden cardiac death affecting typically young and middle-aged women. We report a case of spontaneous coronary artery disease in the postoperative period in a female patient who developed an acute coronary event after gynecologic surgery. The patient was clinically asymptomatic except for mild hemodynamic instability and ST-segment-elevation myocardial infarction seen on electrocardiogram. Spontaneous coronary artery disease was diagnosed with coronary angiography, and a pharmacological therapy was instituted with favorable results.

Spontaneous Coronary Artery Dissection in a Woman: Surgical Treatment and Angiographic Follow-Up

Spontaneous coronary artery dissection constitutes a rare entity that affects mostly women, especially those less than 40 years of age. Treatment of choice is a matter of discussion. It is suggested by many that the therapeutic strategy should be individualized based on each patient's clinical and angiographic manifestations. We present the case of a young woman who underwent surgical revascularization for dissection of the left main stem by using both internal thoracic arteries. Angiographic follow-up revealed resolution of the dissection, obstruction of the right internal thoracic artery graft, and reverse flow in the left internal thoracic artery graft.