Manasrah Nouraldeen, Al Sbihi Ali F, Bell Kendall, Afonso Luis C, Blank Nimrod
Internal Medicine, Detroit Medical Center/Sinai Grace Hospital, Detroit, USA.
Internal Medicine, Wayne State University, Detroit, USA.
Cureus. 2021 Feb 24;13(2):e13539. doi: 10.7759/cureus.13539.
Spontaneous coronary artery dissection (SCAD) is an important and rare cause of myocardial infarction (MI), particularly among young women without traditional atherosclerotic risk factors. Late pregnancy and postpartum period are associated with more risk for developing SCAD. No enough data exist regarding the ideal management of SCAD due to lack of randomized trials comparing medical therapy and revascularization strategies. We present three cases of SCAD, two of them were postpartum women while one involved an obese young woman with no identifiable risk factors. We describe the pathophysiology, types of SCAD, risk factors, clinical presentation, and management approach. This case series highlights the need to raise awareness of SCAD and to facilitate accurate diagnosis promptly.
自发性冠状动脉夹层(SCAD)是心肌梗死(MI)的一个重要且罕见的病因,尤其是在没有传统动脉粥样硬化危险因素的年轻女性中。妊娠晚期和产后时期发生SCAD的风险更高。由于缺乏比较药物治疗和血运重建策略的随机试验,关于SCAD的理想治疗方法尚无足够数据。我们报告三例SCAD病例,其中两例为产后女性,另一例为无明显危险因素的肥胖年轻女性。我们描述了SCAD的病理生理学、类型、危险因素、临床表现及治疗方法。该病例系列强调了提高对SCAD的认识并促进及时准确诊断的必要性。