Rahman Tanvir, Moghadam Reihaneh, Rinder Morton
Internal Medicine, St. Luke's Hospital, Chesterfield, USA.
Cardiology, St. Luke's Hospital, Chesterfield, USA.
Cureus. 2021 Feb 10;13(2):e13263. doi: 10.7759/cureus.13263.
Spontaneous coronary artery dissection (SCAD) is a non-traumatic, non-iatrogenic, and non-atherosclerotic coronary artery disorder that manifests clinically as acute coronary syndrome (ACS), arrhythmia, or sudden cardiac death (SCD). It is a rare cause of ACS (1.7%-4%) and SCD (0.5%), more common in women than men. It was first reported in 1931 in a 42-year-old female at autopsy, who had SCAD after violent retching and vomiting. We report a case of a 51-year-old female who developed sudden-onset chest pain after taking topiramate (TPM). Her chest pain persisted for 1.5 months prior to her outpatient evaluation, which led to further cardiac workup. An urgent left heart catheterization (LHC) revealed a SCAD. Her symptoms improved with percutaneous coronary intervention (PCI), and she was discharged home on aspirin, statins, and beta-blockers.
自发性冠状动脉夹层（SCAD）是一种非创伤性、非医源性且非动脉粥样硬化性的冠状动脉疾病，临床上表现为急性冠状动脉综合征（ACS）、心律失常或心源性猝死（SCD）。它是ACS（1.7%-4%）和SCD（0.5%）的罕见病因，在女性中比男性更常见。1931年首次在一名42岁女性尸检中报告，该女性在剧烈干呕和呕吐后发生了SCAD。我们报告一例51岁女性，服用托吡酯（TPM）后突发胸痛。在门诊评估前，她的胸痛持续了1.5个月，这促使进一步进行心脏检查。紧急左心导管检查（LHC）显示为SCAD。经皮冠状动脉介入治疗（PCI）后她的症状有所改善，出院时服用阿司匹林、他汀类药物和β受体阻滞剂。
