Spontaneous coronary artery dissection in a 50-year-old woman

She was transferred to the nearest hospital with per- • The diagnosis is made at coronary angiography through the cutaneous coronary intervention (PCI) capability for urgent recognition of angiographic patterns of dissection, and coronary angiography. [...] This examination showed normal coronary arteries, Saw classification.5 Spontaneous coronary artery dissection with complete angiographic resolution of the previously noted predominantly involves mid-to-distal coronary arteries, with intramural hematoma and luminal compression of the left main the LAD artery most frequently affected (40%–70%) and the left artery and proximal LAD (Figure 2D), and im. [...] In cases of diagnostic uncertainty, the puted tomography angiograms of the head and neck, and the use of intracoronary imaging such as OCT or intravascular chest, abdomen and pelvis. [...] It represents about only 30% of PCI procedures have successful and durable 4% of all ACS and 35% of ACS in women aged 50 years or results.1 Percutaneous coronary intervention in SCAD is associ- younger.1,2 Spontaneous coronary artery dissection results ated with an increased risk of complications, including iatro- from the development of a spontaneous intimal tear or bleed genic dissection, hemato. [...] The 20% of patients have recurrence with pregnancy, with more than long-term management of patients with SCAD should include 70% of cases of recurrence occurring within the first week post- lifestyle modifications, maintenance of normal blood pres- partum.1 As a result, patients are advised to avoid pregnancy after sure, cardiac rehabilitation, contraception counselling and SCAD.