Recurrent coronary artery dissection of left main trunk initially presented with normal coronary angiography

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• 作者：Masahiko Shibuya ; MD^a ; Kenichi Fujii ; MD ; PhD^b ; Takahiro Imanaka ; MD^a ; Kenji Kawai ; MD^a ; Tomotaka Ando ; MD^a ; Hiroto Tamaru ; MD^a ; Akinori Sumiyoshi ; MD^a ; Tetsuo Horimatsu ; MD^a ; Kenki Ashida ; MD^a ; Ten Saita ; MD^a ; Kumiko Masai ; MD^a ; Reiko Yamasaki ; MD^a ; Shinya Fukui ; MD ; PhD^c ; Yuji Miyamoto ; MD ; PhD^c ; Tohru Masuyama ; MD ; PhD ; FJCC^a ; Masaharu Ishihara ; MD ; PhD ; FJCC^a ; ^{ma-ishihara@hyo-med.ac.jp}
• 关键词：Spontaneous coronary artery dissection ; Sudden cardiac arrest ; Left main coronary artery ; Post-partum ; Acute coronary syndrome
• 刊名：Journal of Cardiology Cases
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：14
• 期：6
• 页码：164-167
• 全文大小：1440 K
• 卷排序：14

文摘

Although spontaneous coronary artery dissection (SCAD) is usually diagnosed by coronary angiography, diagnosis may be missed because of various presentations and imperfections of coronary angiography. We report a case of a 41-year-old female with pregnancy-related SCAD who presented with cardiac arrest. Initial coronary angiography was normal without intimal flap. Unexpectedly, 4 days after admission, SCAD in left main trunk was revealed with recurrent myocardial infarction. Intimal flap was sealed at the time of first angiography and this is an interesting point that made us report this case. SCAD is a rare but not negligible cause of not only acute myocardial infarction but also sudden cardiac arrest even if first coronary angiography is normal.<Learning objective: In a case of a young post-partum woman with resuscitated sudden cardiac arrest who has normal coronary artery, intensive observation is needed. We should be aware that spontaneous coronary artery dissection is a rare but not negligible cause even if initial coronary angiography is normal.>