| A Case of Spontaneous Coronary Artery Dissection: It is Not Always Plaque Rupture. | |
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MedLine Citation:
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PMID: 22560269 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an extremely rare cause of acute coronary syndrome (ACS). Patients may present with a broad spectrum of clinical scenarios, ranging from angina pectoris to myocardial infarction, cardiogenic shock, and sudden death. Standard therapy has not been established; current treatments range from conservative management to percutaneous revascularization or coronary artery bypass surgery. OBJECTIVE: SCAD greatly mimics ACS, and this diagnosis should be considered when evaluating young patients who present with ACS with or without classical risk factors for coronary artery disease. CASE REPORT: We report a case of a 45-year old man who presented with chest pain typical of ACS. He had no risk factors except for a smoking history of 2.5 pack-years. Once the clinical findings suggested acute inferolateral myocardial infarction, the patient underwent emergent cardiac catheterization, which revealed left anterior descending coronary artery dissection. This in itself is not a common cause of inferolateral ST elevation changes on electrocardiogram. CONCLUSION: This case highlights the fact that although SCAD is a rare entity, it is increasingly being recognized as a significant cause of ACS. Urgent angiography should be considered if SCAD is suspected, because early diagnosis and appropriate management significantly improve the outcome in these patients. |
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Authors:
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Sohil Pothiawala; Fatimah Lateef |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-3 |
Journal Detail:
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Title: The Journal of emergency medicine Volume: - ISSN: 0736-4679 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Emergency Medicine, Singapore General Hospital, Singapore. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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