Al-Mahrizi Balqees, Al Kindi Fahad, Al Kindi Faiza, Al Hajri Ruqyia, Al Ismaili Abdullah, Al Kindi Ahmed
Diagnostic Radiology Residency Program, Oman Medical Specialty Board, Muscat, Oman.
Department of Cardiology, Sultan Qaboos University Hospital, Muscat, Oman.
Heart Views. 2024 Jan-Mar;25(1):37-41. doi: 10.4103/heartviews.heartviews_138_23. Epub 2024 Apr 12.
Spontaneous coronary artery dissection (SCAD) is a well-recognized cause of acute coronary syndrome (ACS) which can lead to myocardial infarction and sudden death. Unlike typical atherosclerosis, SCAD operates through distinct pathophysiology, affecting both individuals with and without conventional cardiovascular risk factors. We present a case of a young female presented with retrosternal chest pain radiating to the left arm, mimicking ACS symptoms with mildly elevated troponin levels, and slightly reduced left ventricular ejection fraction (45%). Subsequent evaluation using coronary angiography unveiled a Type 2A SCAD. A comprehensive computed tomography angiography (CTA) of her entire body revealed findings suggestive of fibromuscular dysplasia (FMD) affecting multiple arteries in different sites. Our case entailed the successful management of a young female patient with SCAD stemming from FMD.
自发性冠状动脉夹层(SCAD)是急性冠状动脉综合征(ACS)的一个公认病因,可导致心肌梗死和猝死。与典型的动脉粥样硬化不同,SCAD通过独特的病理生理学机制起作用,影响有和没有传统心血管危险因素的个体。我们报告一例年轻女性病例,该患者出现胸骨后胸痛并向左臂放射,酷似ACS症状,肌钙蛋白水平轻度升高,左心室射血分数略有降低(45%)。随后使用冠状动脉造影进行的评估发现了2A型SCAD。对其全身进行的综合计算机断层扫描血管造影(CTA)显示有提示纤维肌发育异常(FMD)的表现,累及不同部位的多条动脉。我们的病例成功治疗了一名由FMD引起SCAD的年轻女性患者。