Spontan Coronary Artery Dissection: What a Surprise

Gokhan Demirci, T. Aktemur, Mustafa Yıldız
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Abstract

Spontaneous coronary artery dissection (SCAD) is a less recognized form of acute coronary syndrome, often observed in young female patients. Knowledge regarding the diagnosis and treatment of SCAD has increased in recent years, yet gaps in treatment persist. Herein, we present the case of an 18-year-old male student, who, without a regular exercise habit, started a football match on a rug without prior warm-up and experienced exertional chest discomfort, leading him to present to the emergency department with crushing chest pain. The patient, with ST elevation noted, underwent angiography, revealing SCAD in the left anterior descending artery. Managed conservatively, the patient was discharged on the 4th day with successful outcomes. Distinguishing between SCAD and coronary artery occlusion can be challenging, particularly in young patients without any medical history. Moreover, conservative treatment can prevent unnecessary percutaneous coronary intervention and potential complications.
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自发性冠状动脉夹层:真没想到
自发性冠状动脉夹层(SCAD)是一种认知度较低的急性冠状动脉综合征,常发生在年轻女性患者身上。近年来,人们对自发性冠状动脉夹层(SCAD)的诊断和治疗有了更多的了解,但治疗方面的差距依然存在。在此,我们介绍了一例 18 岁男性学生的病例,他没有定期锻炼的习惯,在没有事先热身的情况下在地毯上开始了一场足球比赛,结果出现了劳累性胸部不适,并因压榨性胸痛而到急诊科就诊。患者在接受血管造影检查时发现左前降支动脉有 SCAD,ST 段抬高。经过保守治疗,患者于第 4 天顺利出院。区分 SCAD 和冠状动脉闭塞很有难度,尤其是对于没有任何病史的年轻患者。此外,保守治疗可以避免不必要的经皮冠状动脉介入治疗和潜在并发症。
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