Spontaneous Coronary Artery Dissection: The Phantom Menace

Nikolaos Spinthakis; Nada Abdulkareem; Mohamed Farag; Diana A Gorog

doi:10.14740/cr513w

Spontaneous Coronary Artery Dissection: The Phantom Menace

Nikolaos Spinthakis, Nada Abdulkareem, Mohamed Farag, Diana A Gorog

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Abstract

We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability.

Original language	English
Pages (from-to)	214-217
Number of pages	4
Journal	Cardiology research
Volume	7
Issue number	6
DOIs	https://doi.org/10.14740/cr513w
Publication status	Published - 1 Dec 2016

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Journal Article

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10.14740/cr513wLicence: CC BY

513-3640-1-PBFinal published version, 1.94 MBLicence: CC BY

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title = "Spontaneous Coronary Artery Dissection: The Phantom Menace",

abstract = "We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability.",

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AU - Spinthakis, Nikolaos

AU - Abdulkareem, Nada

AU - Farag, Mohamed

AU - Gorog, Diana A

PY - 2016/12/1

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N2 - We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability.

AB - We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability.

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Spontaneous Coronary Artery Dissection: The Phantom Menace

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