Garibay Carlos, Leker Kristy
Internal Medicine, Eisenhower Medical Center, Rancho Mirage, USA.
Cureus. 2024 Dec 20;16(12):e76080. doi: 10.7759/cureus.76080. eCollection 2024 Dec.
Spontaneous coronary artery dissection (SCAD) is a rare condition that frequently goes undiagnosed. Still, it is becoming an increasingly recognized cause of acute coronary syndrome (ACS), predominantly in middle-aged women with few or no cardiovascular risk factors. We present a case of a 53-year-old female with traditional cardiovascular risk factors, who presented with typical anginal symptoms and was diagnosed with SCAD in the mid to distal left anterior descending artery (LAD). Although she presented with typical risk factors not associated with SCAD, coronary angiography confirmed the diagnosis, and she was successfully managed conservatively with dual antiplatelet therapy (DAPT). This case represents the importance of SCAD remaining as a differential diagnosis even in patients with traditional cardiovascular risk factors. Furthermore, it emphasizes the importance of prompt recognition, appropriate imaging, and individualized management for patients presenting with SCAD, especially as current guidelines lack standardization for follow-up after conservative therapy. This underscores the need for further research to better understand SCAD's etiology and potential advancements in treatment.
自发性冠状动脉夹层(SCAD)是一种罕见的病症,常常未被诊断出来。尽管如此,它正日益成为急性冠状动脉综合征(ACS)的一个公认病因,主要见于几乎没有或没有心血管危险因素的中年女性。我们报告一例53岁有传统心血管危险因素的女性病例,她出现典型心绞痛症状,被诊断为左前降支(LAD)中至远端的SCAD。尽管她存在与SCAD无关的典型危险因素,但冠状动脉造影证实了诊断,并且她通过双联抗血小板治疗(DAPT)成功地接受了保守治疗。该病例表明,即使在有传统心血管危险因素的患者中,SCAD作为鉴别诊断的重要性。此外,它强调了对SCAD患者进行及时识别、适当成像和个体化管理的重要性,特别是因为目前的指南在保守治疗后的随访方面缺乏标准化。这突出了进一步研究以更好地了解SCAD的病因和治疗潜在进展的必要性。