Document Detail


Spontaneous coronary artery dissection causing acute coronary syndrome: an early diagnosis implies a good prognosis.
MedLine Citation:
PMID:  14655234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Spontaneous coronary artery dissection is an unusual cause of acute coronary syndrome. We describe a series of cases that with an early diagnosis and aggressive treatment, which includes percutaneous angioplasty with stent implantation and cardiac surgery, had a good outcome. The objective was to study the demographic characteristics, clinical settings, treatments, and inhospital course of patients with spontaneous coronary artery dissection. We studied a retrospective case series in 3 coronary care units in third-level university hospitals. The spontaneous coronary artery dissection diagnosis was made by coronary angiography. Seven cases of spontaneous coronary artery dissections were recorded. They were 5 women and 2 men. The age range was 28 to 64 years. Two of them took oral contraceptives and one case occurred in the postpartum period. An acute anterior wall myocardial infarction was the most frequent clinical presentation, occurring in 4 of the 7 cases. In fact, the left anterior descending artery was involved in 6 cases. An urgent coronary angiogram was performed in all cases. Definitive treatment included percutaneous angioplasty and stent implantation in 3 cases, coronary artery bypass surgery in 2 case, and cardiac transplantation in another case. One patient was treated medically. None of the patients died in the hospital. Spontaneous coronary artery dissection remains an unusual cause of acute coronary syndrome. It should be included in the differential diagnosis of acute myocardial infarction, especially when it affects young, healthy females. An early clinical suspicion and diagnosis with urgent coronary angiography and aggressive treatment that includes percutaneous angioplasty with stent implantation and cardiac surgery could improve the prognosis of these patients.
Authors:
Sebastian Roig; José A Gómez; Miguel Fiol; Josep Guindo; Jon Pérez; Andrés Carrillo; Enrique Esplugas; Antonio Bayés de Luna
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  21     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-05     Completed Date:  2004-01-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  549-51     Citation Subset:  IM    
Affiliation:
Coronary and Intensive Care Unit, Hospital Son Dureta, C/Andrea Doria 55, 07014 Palma de Mallorca, Spain.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aneurysm, Dissecting / complications*,  diagnosis*,  therapy
Angina, Unstable / diagnosis*,  etiology*,  therapy
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Aneurysm / complications*,  diagnosis*,  therapy
Coronary Angiography
Coronary Artery Bypass
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*,  etiology*,  therapy
Prognosis
Retrospective Studies
Stents
Syndrome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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