An Unusual Case of Spontaneous Coronary Artery Dissection

Background: Spontaneous coronary artery dissection (SCAD) is a relatively rare cause of acute coronary syndrome. SCAD usually occurs both in young women or multiparous women either during pregnancy or in early post-partum period. Here we report an unusual case of SCAD in a middle-aged woman with no predisposing factors for SCAD. Case Summary: A 42-year old female presented with intermittent chest pain, obstetrical history of one child birth seven years back and currently with no other cardiac risk factors. Electrocardiogram showed T-wave inversions in the anterior leads. Stress cardiolite test showed mild partially reversible defect involving anterior/anterio-septal wall. Coronary angiography was performed and SCAD was observed in left anterior descending artery (LAD). She underwent percutaneous coronary angioplasty and stenting, was hemodynamically stable and was later discharged in good condition with the alleviation in symptoms. Discussion: SCAD usually occurs in young patients during pregnancy or in early post-partum period but it should also be considered in middle aged women unrelated with pregnancy. We suggest that women especially who do not have any cardiac risk factors, should not be treated with thrombolytic.