Spontaneous Coronary Artery Dissection : The Phantom Menace

Spinthakis, Nikolaos, Abdulkareem, Nada, Farag, Mohamed and Gorog, Diana A (2016) Spontaneous Coronary Artery Dissection : The Phantom Menace. Cardiology research, 7 (6). pp. 214-217. ISSN 1923-2829
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We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability.


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