Conservative management of spontaneous coronary artery dissection: a case report

Abstract

Spontaneous coronary artery dissection (SCAD) is a
rare cause of acute coronary syndromes (ACS) that
mainly occurs in young women with no risk factors
and no coronary atherosclerosis. Diagnosis is made
by invasive coronary angiography (CA), computed
tomography coronary angiography (CTCA),
intravascular ultrasound (IVUS) and optical
coherence tomography (OCT). The rarity of this
entity as well as the complications of invasive
treatment make it difficult to choose therapy
between conservative management, percutaneous
coronary intervention (PCI) or coronary artery
bypass grafting (CABG). We report a case of a 36-
year-old woman presented with non ST elevation
myocardial infarction (NSTEMI) related to
spontaneous dissection of coronary arteries (left
main trunk, left anterior descending artery and left
circumflex artery) treated medically with
spectacular results at 2 months, controlled by CTCA.