Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event”
Spontaneous coronary artery dissection (SCAD) is an unusual, but increasingly recognized, cause of ST-elevation myocardial infarction (STEMI), especially among younger patients without conventional risk factors for coronary artery disease (CAD). Although dissection of the coronary intima or media is...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2015/597234 |
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| author | George Kassimis Athanasios Manolis Jonathan N. Townend |
| author_facet | George Kassimis Athanasios Manolis Jonathan N. Townend |
| author_sort | George Kassimis |
| collection | DOAJ |
| description | Spontaneous coronary artery dissection (SCAD) is an unusual, but increasingly recognized, cause of ST-elevation myocardial infarction (STEMI), especially among younger patients without conventional risk factors for coronary artery disease (CAD). Although dissection of the coronary intima or media is a hallmark finding, hematoma formation within the vessel wall is often present. It remains unclear whether dissection or hematoma is the primary event, but both may cause luminal stenosis and occlusion. The diagnosis of SCAD is made principally with invasive coronary angiography, although adjunctive intracoronary imaging modalities may increase the diagnostic yield. In STEMI patients, the decision whether to pursue primary percutaneous coronary intervention (PCI) or appropriate conservative medical therapy is based on clinical presentation, the extent of the dissection, the critical anatomy involvement, and the amount of ischaemic myocardium at risk. In this case report, we present two cases of young women with SCAD and STEMI, successfully treated with primary PCI. We briefly illustrate the characteristic aspects of the angiographic presentation and intravascular ultrasound-guided treatment. SCAD should always be considered in young STEMI patients without conventional risk factors for CAD with primary angioplasty to be required in patients with ongoing myocardial ischemia. |
| format | Article |
| id | doaj-art-e9f01ba8817848929d0d5a60fbb96388 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-e9f01ba8817848929d0d5a60fbb963882025-08-20T03:26:35ZengWileyCase Reports in Cardiology2090-64042090-64122015-01-01201510.1155/2015/597234597234Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event”George Kassimis0Athanasios Manolis1Jonathan N. Townend2Department of Cardiology, Asklepeion General Hospital, Athens, GreeceDepartment of Cardiology, Asklepeion General Hospital, Athens, GreeceDepartment of Cardiology, Queen Elizabeth Hospital, Birmingham, UKSpontaneous coronary artery dissection (SCAD) is an unusual, but increasingly recognized, cause of ST-elevation myocardial infarction (STEMI), especially among younger patients without conventional risk factors for coronary artery disease (CAD). Although dissection of the coronary intima or media is a hallmark finding, hematoma formation within the vessel wall is often present. It remains unclear whether dissection or hematoma is the primary event, but both may cause luminal stenosis and occlusion. The diagnosis of SCAD is made principally with invasive coronary angiography, although adjunctive intracoronary imaging modalities may increase the diagnostic yield. In STEMI patients, the decision whether to pursue primary percutaneous coronary intervention (PCI) or appropriate conservative medical therapy is based on clinical presentation, the extent of the dissection, the critical anatomy involvement, and the amount of ischaemic myocardium at risk. In this case report, we present two cases of young women with SCAD and STEMI, successfully treated with primary PCI. We briefly illustrate the characteristic aspects of the angiographic presentation and intravascular ultrasound-guided treatment. SCAD should always be considered in young STEMI patients without conventional risk factors for CAD with primary angioplasty to be required in patients with ongoing myocardial ischemia.http://dx.doi.org/10.1155/2015/597234 |
| spellingShingle | George Kassimis Athanasios Manolis Jonathan N. Townend Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event” Case Reports in Cardiology |
| title | Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event” |
| title_full | Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event” |
| title_fullStr | Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event” |
| title_full_unstemmed | Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event” |
| title_short | Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event” |
| title_sort | spontaneous coronary artery dissection intramural haematoma in young women with st elevation myocardial infarction it is not always a plaque rupture event |
| url | http://dx.doi.org/10.1155/2015/597234 |
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