ARYA Atherosclerosis Journal

Unusual presentation of extensive spontaneous coronary dissection: Case report and literature review

Document Type : Case Report

Authors

Júlio César Queiroz França 1
Márcio Antonio Santos 2
Moacir Fernandes Godoy 3

1 Resident Physician, Department of Cardiology, Hospital de Base, Faculty of Medicine of São José do Rio Preto (FAMERP), São Paulo, Brazil

2 Associate Professor, Department of Hemodynamics and Interventional Cardiology, Faculty of Medicine of São José do Rio Preto (FAMERP), São Paulo, Brazil

3 Adjunct Professor, Department of Cardiology and Cardiovascular Surgery, Faculty of Medicine of São José do Rio Preto (FAMERP), São Paulo, Brazil

Abstract
BACKGROUND: The etiology of spontaneous dissection of coronary artery (SDCA) is not well understood yet. Different studies have linked this entity to pregnancy, physical stress, collagen diseases and vasculitis. In general, patients do not exhibit the classic risk factors for coronary artery disease, which mandates the suspicion of this condition, especially in young adults with acute coronary syndrome. CASE REPORT: In this article, we report the case of a 63-year old male patient, asymptomatic, who came for periodic evaluation and after evaluation by exercise and myocardial scintigraphy had high suspicion for severe coronary artery disease and underwent coronary angiography, which showed spontaneous dissection of the left and right branches of the coronary arteries. CONCLUSION: The choice of therapeutic strategies (clinics, percutaneous or surgical) remains uncertain and should be individualized by the features and form of presentation of the SDCA.   

Keywords

Dissection
Coronary Angiography
Coronary
Computed Tomography Angiography (CTA)
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ARYA Atherosclerosis Journal
Volume 13, Issue 1 - Serial Number 1
January and February 2017
Pages 46-49

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