Spontaneous coronary artery dissection: Still a lot to learn

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• 作者：David Neves ; ^{dcneves25@hotmail.com} ; Â ; ngela Bento ; Renato Fernandes ; Lino Patrí ; cio ; José ; Aguiar
• 关键词：Spontaneous coronary artery dissection ; Optical coherence tomography ; Percutaneous coronary intervention
• 刊名：Revista Portuguesa de Cardiologia (English Edition)
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：36
• 期：1
• 页码：59.e1-59.e5
• 全文大小：947 K
• 卷排序：36

文摘

Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is an uncommon but probably underdetected pathological substrate for acute coronary syndrome. Clinical associations have been noted, like female gender and young age, but its pathophysiology is not yet fully understood. In this report we describe the case of a 50-year-old woman, without cardiovascular risk factors presenting with non-ST segment elevation myocardial infarction, in whom SCAD was diagnosed. Treatment was initially conservative but due to aggravation of the dissection she eventually underwent a complex percutaneous coronary intervention, requiring implantation of multiple stents, but with a good clinical outcome. The procedure was guided by optical coherence tomography (OCT). Carefully analyzing the combined pictures of OCT and angiography, the dissection appeared to be filled with a clear fluid, but not contrast.