Spontaneous Coronary Artery Dissection in a Young Woman Presenting with Acute Myocardial Infarction

 Sanad Syam⁽¹⁾ • Amal I.Alawadat⁽²⁾ •  Nour Alaqqad⁽¹⁾ • Dania Al-Ghalayini⁽¹⁾ , etc..

Published in Academic Anesthesia Journal  https://doi.org/10.62186/GFWU8995

Google Scholar Index: p.145177.

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare but important cause of acute myocardial infarction (AMI), particularly in young women without traditional cardiovascular risk factors. Early recognition and diagnosis using coronary angiography, supplemented by intravascular imaging such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT), is essential for accurate diagnosis and management, which can range from conservative therapy to percutaneous or surgical intervention. We report the case of a 32-year-old woman who presented with acute chest pain and elevated cardiac biomarkers. Electrocardiography revealed ST-segment elevation in the anterior leads. Emergent coronary angiography demonstrated a mid-left anterior descending (LAD) artery dissection with preserved distal flow, which was confirmed by OCT. The patient was managed conservatively with dual antiplatelet therapy and beta-blockers. She remained stable, with resolution of symptoms and normalization of cardiac enzymes. Follow-up imaging at 3 and 12 months demonstrated complete healing of the dissected vessel. This case emphasizes the importance of considering SCAD in young women presenting with AMI, highlights the role of advanced coronary imaging in diagnosis and risk stratification, and supports individualized management strategies.

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