A Challenging Case of Extensive Spontaneous Coronary Artery Dissection

Nupoor Narula; Harsimran Singh; Udhay Krishnan; Christopher Sciria; Adam Vohra; Jiwon Kim; Christopher Lau; Dmitriy Feldman; Luke Kim; Julie L Friedman

doi:10.1016/j.jaccas.2020.07.005

A Challenging Case of Extensive Spontaneous Coronary Artery Dissection

JACC Case Rep. 2020 Aug 19;2(10):1437-1442. doi: 10.1016/j.jaccas.2020.07.005. eCollection 2020 Aug.

Authors

Affiliations

¹ Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York.
² Department of Cardiothoracic Surgery, Weill Cornell Medical College, New York, New York.

Abstract

The detection of spontaneous coronary artery dissection (SCAD) causing myocardial infarction is integral in pursuing the appropriate management. Our case posed a diagnostic challenge, with Takotsubo cardiomyopathy and coronary embolism among the potential differential diagnoses upon the initial presentation. Extensive propagation of spontaneous coronary artery dissection subsequently resulted in a significant challenge to management requiring surgical revascularization. (Level of Difficulty: Intermediate.).

Keywords: ACS, acute coronary syndrome; CABG, coronary artery bypass graft; CMR, cardiac magnetic resonance; ECG, electrocardiogram; LAD, left anterior descending artery; LGE, late gadolinium enhancement; LM, left main; MI, myocardial infarction; MINOCA, myocardial infarction with nonobstructive coronary arteries; SCAD, spontaneous coronary artery dissection; TTC, Takotsubo cardiomyopathy; Takotsubo cardiomyopathy; spontaneous coronary artery dissection; women’s health.

Publication types

Case Reports