Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection?
Introduction. Spontaneous coronary artery dissection (SCAD) is a very rare disease with poor prognosis. It mainly affects young women free of risk factors for coronary artery disease (CAD) and women during the peripartum period. The prognosis for myocardial infarction caused by SCAD is poor...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2015-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501506536J.pdf |
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| author | Jović Zoran Obradović Slobodan Đenić Nemanja Mladenović Zorica Đurić Predrag Spasić Marijan Tavčiovski Dragan |
| author_facet | Jović Zoran Obradović Slobodan Đenić Nemanja Mladenović Zorica Đurić Predrag Spasić Marijan Tavčiovski Dragan |
| author_sort | Jović Zoran |
| collection | DOAJ |
| description | Introduction. Spontaneous coronary artery dissection (SCAD) is a very rare
disease with poor prognosis. It mainly affects young women free of risk
factors for coronary artery disease (CAD) and women during the peripartum
period. The prognosis for myocardial infarction caused by SCAD is poor,
management is often difficult and guidelines still missing. Case report. We
presented a woman with acute myocardial infarction of anterior wall of the
left ventricle, caused by spontaneous dissection of medial segment of the
left anterior descending coronary artery. We treated the patient with
thrombolytic therapy and performed coronary angiography after that. Finally
we decided to do nothing more. Two years later we performed coronary
angiography again and founded the coronary artery normal. We also analyzed
19 cases publiched from 1996 to 2012 when coronary artery dissection had
been treated with thrombolytic agent. Analysis revealed only one case of 19,
with complication after treating SCAD with thrombolysis. Conclusion.
Sometimes, regarding myocardial infarction in young women with no risk
factors for CAD, especially in young women in peripartum, we should think
about SCAD. The presented case, like eight others, demonstrates that good
clinical outcomes can be achieved with thrombolysis. In spite of all this,
we still need more data to verify that thrombolysis does not have to harm
the therapy for SCAD. For the time being thrombolytic therapy could be an
option. |
| format | Article |
| id | doaj-art-41f523159a8f4a0ea2457d7aabb0e1c2 |
| institution | OA Journals |
| issn | 0042-8450 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-41f523159a8f4a0ea2457d7aabb0e1c22025-08-20T02:16:28ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502015-01-0172653654010.2298/VSP1506536J0042-84501506536JDoes thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection?Jović Zoran0Obradović Slobodan1Đenić Nemanja2Mladenović Zorica3Đurić Predrag4Spasić Marijan5Tavčiovski Dragan6Military Medical Academy, Clinic for Cardiology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Emergency and Internal Medicine, BelgradeUniversity of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Cardiology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Cardiology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Cardiology, BelgradeMilitary Medical Academy, Clinic for Cardiology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeIntroduction. Spontaneous coronary artery dissection (SCAD) is a very rare disease with poor prognosis. It mainly affects young women free of risk factors for coronary artery disease (CAD) and women during the peripartum period. The prognosis for myocardial infarction caused by SCAD is poor, management is often difficult and guidelines still missing. Case report. We presented a woman with acute myocardial infarction of anterior wall of the left ventricle, caused by spontaneous dissection of medial segment of the left anterior descending coronary artery. We treated the patient with thrombolytic therapy and performed coronary angiography after that. Finally we decided to do nothing more. Two years later we performed coronary angiography again and founded the coronary artery normal. We also analyzed 19 cases publiched from 1996 to 2012 when coronary artery dissection had been treated with thrombolytic agent. Analysis revealed only one case of 19, with complication after treating SCAD with thrombolysis. Conclusion. Sometimes, regarding myocardial infarction in young women with no risk factors for CAD, especially in young women in peripartum, we should think about SCAD. The presented case, like eight others, demonstrates that good clinical outcomes can be achieved with thrombolysis. In spite of all this, we still need more data to verify that thrombolysis does not have to harm the therapy for SCAD. For the time being thrombolytic therapy could be an option.http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501506536J.pdfacute coronary syndromeaneurysm dissectingmyocardial infarctionfibrinolytic agentstreatment outcome |
| spellingShingle | Jović Zoran Obradović Slobodan Đenić Nemanja Mladenović Zorica Đurić Predrag Spasić Marijan Tavčiovski Dragan Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection? Vojnosanitetski Pregled acute coronary syndrome aneurysm dissecting myocardial infarction fibrinolytic agents treatment outcome |
| title | Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection? |
| title_full | Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection? |
| title_fullStr | Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection? |
| title_full_unstemmed | Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection? |
| title_short | Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection? |
| title_sort | does thrombolytic therapy harm or help in st elevation myocardial infarction stemi caused by the spontaneous coronary dissection |
| topic | acute coronary syndrome aneurysm dissecting myocardial infarction fibrinolytic agents treatment outcome |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501506536J.pdf |
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