Conservative Management of Spontaneous Coronary Artery Dissection of the Left Main Coronary Artery: A Case Report

Abstract. Spontaneous coronary artery dissection is a non-atherosclerotic cause of acute coronary syndrome, particularly among young women. A 46-year-old female without a family history of cardiac disease and traditional atherosclerotic risk factors presented to hospital with non-ST-segment elevatio...

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Bibliographic Details
Main Authors: Ming Zhang, Jibin Chen, Xiuyan Lu, Bin Wang, Wei Xia, Hanjia Gao
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2025-03-01
Series:Cardiology Discovery
Online Access:http://journals.lww.com/10.1097/CD9.0000000000000144
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Summary:Abstract. Spontaneous coronary artery dissection is a non-atherosclerotic cause of acute coronary syndrome, particularly among young women. A 46-year-old female without a family history of cardiac disease and traditional atherosclerotic risk factors presented to hospital with non-ST-segment elevation myocardial infarction. Diagnostic coronary angiography revealed moderate stenosis of the left main coronary artery and the left anterior descending artery with blood flow thrombolysis in myocardial infarction grade 3. The left circumflex artery was observed hypoplastic without significant stenosis. Intravascular ultrasound revealed an extensive intramural hematoma from the middle of the left anterior descending branch to the left main trunk and a compressed lumen with intact intima. The patient underwent conservative treatment and remained asymptomatic 11 months after discharge. Repeat coronary computed tomography angiography showed haematoma absorption with stenosis relief. Spontaneous coronary artery dissection of the left main coronary artery is relatively rare. Its management is based on the patient’s clinical condition and lesion characteristics.
ISSN:2096-952X
2693-8499