Shoja Tannaz, Basman Craig, Jain Suresh, Mangla Aditya, Lasic Zoran
Jamaica Hospital Medical Center, 8900 Van Wyck Expy, Richmond Hill, NY 11418, USA.
Lenox Hill Hospital Medical Center, 100 E 77th St, New York, NY 10075, USA.
Cardiol Res. 2017 Dec;8(6):327-330. doi: 10.14740/cr587w. Epub 2017 Dec 22.
Spontaneous coronary artery dissection (SCAD) is a rare entity that can cause acute myocardial infarction and sudden cardiac death (SCD) which often goes unrecognized. We report a case of SCAD in a young postpartum female who presented with sudden cardiac arrest. The patient was managed medically and found to have fibromuscular dysplasia (FMD). After being stabilized in the critical care unit, coronary angiography was performed which showed dissection of the left main artery, intramural hematoma, and the culprit lesion. Further investigation showed dissection of the left vertebral artery which was all consistent with a diagnosis of FMD. The patient was followed as an outpatient and a repeated coronary angiography demonstrated healed dissection site. In conclusion, this case exemplifies that prompt diagnosis along with medical management without the need of coronary artery bypass graft, and percutaneous coronary intervention can improve survival in SCAD.
自发性冠状动脉夹层（SCAD）是一种罕见的病症，可导致急性心肌梗死和心源性猝死（SCD），且常常未被识别。我们报告一例年轻产后女性发生SCAD并出现心搏骤停的病例。该患者接受了药物治疗，发现患有纤维肌发育不良（FMD）。在重症监护病房病情稳定后，进行了冠状动脉造影，结果显示左主干动脉夹层、壁内血肿及罪犯病变。进一步检查显示左椎动脉夹层，这一切均符合FMD的诊断。该患者作为门诊病人接受随访，重复冠状动脉造影显示夹层部位已愈合。总之，该病例表明，及时诊断并进行药物治疗，无需冠状动脉旁路移植术和经皮冠状动脉介入治疗，可提高SCAD患者的生存率。
