Suresh Avanti, Parhar Amardeep S, Singh Kerry S, Al-Bayati Asseel, Apolito Renato
Internal Medicine, Jersey Shore University Medical Center, Neptune City, USA.
Internal Medicine, St. George's University, Neptune City, USA.
Cureus. 2020 Nov 30;12(11):e11801. doi: 10.7759/cureus.11801.
Heart attacks in young populations are frequently misdiagnosed as reflux disease or anxiety. Spontaneous coronary artery dissection (SCAD) is a coronary artery disease that classically manifests around the age of 45 years and has a fatal outcome if missed. Since it was first described in 1931, our understanding of SCAD has evolved tremendously, particularly with the advent of advanced coronary angiography. Electrocardiograms can show abnormality in the ST-segment, with an elevation of cardiac damage markers. The involvement of the coronary arteries is variable. The left main coronary artery is frequently reported as the main culprit. We are hereby reporting a case of SCAD in a young woman who presented with a heart attack. Particularly, her age is younger than the reported cases, cardiac catheterization revealed a left main artery dissection with a thrombolytic extension, and her complicated case was managed with coronary artery bypass and heart transplantation.
年轻人群中的心脏病发作常常被误诊为反流性疾病或焦虑症。自发性冠状动脉夹层（SCAD）是一种冠状动脉疾病，通常在45岁左右发病，如果漏诊会导致致命后果。自1931年首次被描述以来，我们对SCAD的认识有了巨大的发展，尤其是随着先进冠状动脉血管造影技术的出现。心电图可显示ST段异常，心脏损伤标志物升高。冠状动脉的受累情况各不相同。左冠状动脉主干常被认为是主要病因。我们在此报告一例年轻女性SCAD患者，她以心脏病发作就诊。特别的是，她的年龄比已报道病例更小，心脏导管检查显示左主干动脉夹层并有溶栓扩展，她的复杂病例通过冠状动脉搭桥和心脏移植进行了治疗。
