Abstract
Five cases of spontaneous coronary artery dissection (SCAD) are reported, three in women and two in men (mean age 44 years; range 28-65), all of whom suffered a myocardial infarction. Common risk factors for coronary artery disease were present in the two men; in the female group one patient was taking an oral contraceptive, one was in the postpartum period, and the third was a smoker. Only the three women received intravenous alteplase and their ejection fraction was normal; both men had impaired left ventricular function. Two patients had SCAD of the left anterior descending coronary artery and three of the right coronary artery. Only the two men had angiographic features of coronary atherosclerotic involvement. No patients required surgical revascularisation or percutaneous transluminal coronary angioplasty. At a mean follow up of 27 months (range 6 to 40) all patients were alive and all but one were asymptomatic.
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- Barger A. C., Beeuwkes R., 3rd, Lainey L. L., Silverman K. J. Hypothesis: vasa vasorum and neovascularization of human coronary arteries. A possible role in the pathophysiology of atherosclerosis. N Engl J Med. 1984 Jan 19;310(3):175–177. doi: 10.1056/NEJM198401193100307. [DOI] [PubMed] [Google Scholar]
- Barrett J. M., Van Hooydonk J. E., Boehm F. H. Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv. 1982 Sep;37(9):557–566. doi: 10.1097/00006254-198209000-00001. [DOI] [PubMed] [Google Scholar]
- Cocco P., Thiene G., Corrado D., Lodovichetti G., Pennelli N. Ematoma (aneurisma) dissecante spontaneo delle coronarie e morte improvvisa. G Ital Cardiol. 1990 Sep;20(9):795–800. [PubMed] [Google Scholar]
- Davis K., Kennedy J. W., Kemp H. G., Jr, Judkins M. P., Gosselin A. J., Killip T. Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS). Circulation. 1979 Jun;59(6):1105–1112. doi: 10.1161/01.cir.59.6.1105. [DOI] [PubMed] [Google Scholar]
- DeMaio S. J., Jr, Kinsella S. H., Silverman M. E. Clinical course and long-term prognosis of spontaneous coronary artery dissection. Am J Cardiol. 1989 Sep 1;64(8):471–474. doi: 10.1016/0002-9149(89)90423-2. [DOI] [PubMed] [Google Scholar]
- Gonzalez J. I., Hill J. A., Conti C. R. Spontaneous coronary artery dissection treated with percutaneous transluminal angioplasty. Am J Cardiol. 1989 Apr 1;63(12):885–886. doi: 10.1016/0002-9149(89)90068-4. [DOI] [PubMed] [Google Scholar]
- Grady A. E., Cowley M. J., Vetrovec G. W. Traumatic dissecting coronary arterial aneurysm with subsequent complete healing. Am J Cardiol. 1985 May 1;55(11):1424–1425. doi: 10.1016/0002-9149(85)90518-1. [DOI] [PubMed] [Google Scholar]
- Himbert D., Makowski S., Laperche T., Steg P. G., Juliard J. M., Gourgon R. Left main coronary spontaneous dissection: progressive angiographic healing without coronary surgery. Am Heart J. 1991 Dec;122(6):1757–1759. doi: 10.1016/0002-8703(91)90293-q. [DOI] [PubMed] [Google Scholar]
- Ramamurti S., Mahrer P. R., Magnusson P., Bowyer J. V., Sasse L., Shaperman M. Idiopathic coronary artery dissection: a rare in vivo diagnosis. Clin Cardiol. 1985 Jan;8(1):57–60. doi: 10.1002/clc.4960080109. [DOI] [PubMed] [Google Scholar]
- Robinowitz M., Virmani R., McAllister HA JrU Spontaneous coronary artery dissection and eosinophilic inflammation: a cause and effect relationship? Am J Med. 1982 Jun;72(6):923–928. doi: 10.1016/0002-9343(82)90853-1. [DOI] [PubMed] [Google Scholar]
- Thayer J. O., Healy R. W., Maggs P. R. Spontaneous coronary artery dissection. Ann Thorac Surg. 1987 Jul;44(1):97–102. doi: 10.1016/s0003-4975(10)62372-7. [DOI] [PubMed] [Google Scholar]
- Vacek J. L., McKiernan T. L. Intracoronary streptokinase for acute coronary-artery dissection. N Engl J Med. 1984 May 3;310(18):1187–1187. doi: 10.1056/NEJM198405033101815. [DOI] [PubMed] [Google Scholar]
- Vicari R., Eybel C., Monson D. Survival following spontaneous coronary artery dissection: surgical repair by extrusion of intramural hematoma. Am Heart J. 1986 Mar;111(3):593–594. doi: 10.1016/0002-8703(86)90069-4. [DOI] [PubMed] [Google Scholar]
- van der Bel-Kahn J. Recurrent primary coronary artery dissecting aneurysm (hematoma). Am J Clin Pathol. 1982 Sep;78(3):394–398. doi: 10.1093/ajcp/78.3.394. [DOI] [PubMed] [Google Scholar]