A Young Male With SCAD: Challenging Conventional Risk Factors and Insights

Abstract

Spontaneous coronary artery dissection (SCAD) is a relatively rare and underdiagnosed condition that can lead to acute coronary syndrome (ACS), with a notable incidence in young female patients without traditional cardiovascular risk factors. We present an unusual case of SCAD in a young male patient in the absence of common predisposing factors such as fibromuscular dysplasia (FMD), connective tissue disorders, and systemic inflammatory conditions. A 29-year-old man presenting with chest pain was diagnosed with SCAD involving the left anterior descending artery (LAD), resulting in an acute myocardial infarction (MI). Coronary angiography revealed a 100% occlusion, and successful angioplasty and stenting were performed. The patient was started on dual antiplatelet therapy along with other therapeutic approaches. Seven months post-intervention, his ejection fraction improved, and statin therapy was discontinued due to the absence of atherosclerotic disease. SCAD should be suspected in younger patients with ACS-like symptoms in the absence of traditional risk factors. Tailored medical therapy, psychological support, and comprehensive evaluation for underlying causes, such as extracoronary vascular abnormalities (EVAs), are critical to recovery and prevention of recurrence. A multidisciplinary approach, balancing conservative, and interventional strategies is essential for optimizing outcomes in SCAD.