Besinger BR, Gardner S. Spontaneous coronary artery dissection in a 27-year-old woman.
J Emerg Med 2012;
44:e239-42. [PMID:
22917653 DOI:
10.1016/j.jemermed.2012.07.042]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 03/18/2012] [Accepted: 07/03/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Spontaneous coronary artery dissection (SCAD) causes acute coronary syndromes or sudden death in young patients who are often lacking classic coronary disease risk factors. Systemic inflammatory and connective tissue diseases have been suggested as risk factors for SCAD.
OBJECTIVE
To review the risk factors, diagnosis, and management of this uncommon but life-threatening disease.
CASE REPORT
We report a case of a 27-year-old woman with a history of an ill-defined inflammatory arthropathy who presented with an acute ST-elevation myocardial infarction. SCAD was diagnosed by coronary angiography. Percutaneous coronary intervention was attempted but was unsuccessful. The patient recovered uneventfully with medical management and was ultimately diagnosed with systemic lupus erythematosus.
CONCLUSIONS
SCAD is a rare but important cause of acute coronary syndromes and sudden death. It commonly occurs in young women. Although pregnancy is the most well-established risk factor, systemic inflammatory and connective tissue diseases have also been suggested as risk factors.
Collapse