Asian Journal of Case Reports in Medicine and Health

Spontaneous Coronary Dissection Revealed by Ventricular Tachycardia in a Female Patient: A Case Report and Review of Literature

Hanaa El-Ghiati *

Department of Cardiology, Military Teaching Hospital of Rabat, Morocco.

Bachir Mesfioui

Department of Cardiology, National League of Cardiovascular Diseases of Rabat, Morocco.

Kawtar Afrikh

Department of Cardiology, National League of Cardiovascular Diseases of Rabat, Morocco.

Rokya Fellat

Department of Cardiology, National League of Cardiovascular Diseases of Rabat, Morocco.

Nadia Fellat

Department of Cardiology, National League of Cardiovascular Diseases of Rabat, Morocco.

*Author to whom correspondence should be addressed.

---

Abstract

Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome or sudden death, typically observed in patients with minimal atherosclerotic risk factors. A 53-year-old female patient presented to the emergency department with episodes of palpitations and sudden, intense chest pain radiating to the back. Following the chest pain, she experienced a brief loss of consciousness. The initial electrocardiogram (EKG) revealed a self-resolving episode of ventricular tachycardia. A transthoracic echocardiogram displayed enlarged ventricles with significant regional wall motion abnormalities and reduced left ventricular ejection fraction. Cardiac catheterization revealed an intimal dissection in the middle segment of the left anterior descending artery. The patient was managed conservatively and exhibited stable angiographic findings during a follow-up evaluation one month later.

Keywords: Artery, coronary, dissection, coronary angiography

---

---

---

References

Biswas M, Sethi A, Voyce S. Spontaneous coronary artery dissection: Case report and review of literature. Heart Views [Internet]. 201213(4):149. [cited 2021 Jan 25] Available:http://www.heartviews.org/text.asp?2012/13/4/149/105737 DOI: 10.4103/1995-705X.105737

García-Guimaraes M, Bastante T, Macaya F, Roura G, Sanz R, Alvarado JCB, et al. Spontaneous coronary artery dissection in Spain: Clinical and angiographic characteristics, management, and in-hospital events. Revista Española de Cardiología (English Edition). 2020; 74(1):15–23. DOI: 10.1016/j.rec.2020.04.002

Dubey L. A rare case of stenting of spontaneous dissection of Shepherd’s Crook right coronary artery. ARYA Atherosclerosis. 2014;10(2):129.

Sharma S, Kaadan MI, Duran JM, Ponzini F, Mishra S, Tsiaras SV, et al. Risk factors, imaging findings, and sex differences in spontaneous coronary artery dissection. The American Journal of Cardiology. 2019; 123(11):1783–7. DOI: 10.1016/j.amjcard.2019.02.040

Saw J, Starovoytov A, Humphries K, Sheth T, So D, Minhas K, et al. Canadian spontaneous coronary artery dissection cohort study: In-hospital and 30-day outcomes. European Heart Journal. 2019; 40(15):1188–97. DOI: 10.1093/eurheartj/ehz007

Lettieri C, Zavalloni D, Rossini R, Morici N, Ettori F, Leonzi O, et al. Management and long-term prognosis of spontaneous coronary artery dissection. The American Journal of Cardiology. 2015;116(1):66–73. DOI: 10.1016/j.amjcard.2015.03.039

Saw J, Humphries K, Aymong E, Sedlak T, Prakash R, Starovoytov A, et al. Spontaneous coronary artery dissection: Clinical outcomes and risk of recurrence. Journal of the American College of Cardiology. 2017;70(9):1148–58. DOI: 10.1016/j.jacc.2017.06.053

Tweet MS, Eleid MF, Best PJ, Lennon RJ, Lerman A, Rihal CS, et al. Spontaneous coronary artery dissection: Revascularization versus conservative therapy. Circulation: Cardiovascular Interventions. 2014;7(6):777–86. DOI: 10.1161/CIRCINTERVENTIONS.114.001659

Cheung CC, Starovoytov A, Parsa A, Andrade JG, Krahn AD, Bennett M, et al. In-hospital and long-term outcomes among patients with spontaneous coronary artery dissection presenting with ventricular tachycardia/ fibrillation. Heart Rhythm. 2020;17(11): 1864–9. DOI: 10.1016/j.hrthm.2020.06.019

Phan D, Clare R, Duan L, Kim C, Moore N, Lee M-S. Characteristics and outcomes of patients with spontaneous coronary artery dissection who suffered sudden cardiac arrest. Journal of Interventional Cardiac Electrophysiology. 2020;1–7. DOI: 10.1007/s10840-019-00695-9

Tweet MS, Kok SN, Hayes SN. Spontaneous coronary artery dissection in women: What is known and what is yet to be understood. Clinical Cardiology. 2018 Feb;41(2):203-10.

Alfonso F, Paulo M, Gonzalo N, et al. Diagnosis of spontaneous coronary artery dissection by optical coherence tomography. J Am Coll Cardiol. 2012; 59:1073–1079.