Table 2.
Reported cases of spontaneous coronary artery dissection in patients with COVID-19.
Author | Age/Sex | PMH | Presentation | Angiography findings | COVID diagnosis | Treatment |
---|---|---|---|---|---|---|
Kumar [26] | 48/F | Migraine, hyperlipidemia | Severe retrosternal chest pain | SCAD (LAD); tapered compression of 70% was noted at the mid through distal LAD with reconstitution at the apex. Delayed contrast washout was noted in the proximal LAD indicating the proximal extent of the dissection. | Positive nasopharyngeal swab | Medical therapy (aspirin 81 mg daily and clopidogrel 75 mg daily) |
Courand [31] | 55/M | Peripheral artery disease | Cough, fever, dyspnea, chest pain | SCAD (RCA); total occlusion of the posterior descending artery with epicardial collateral from the left anterior descending artery. In the mid-right coronary artery, a spontaneous dissecting coronary hematoma was observed with an intimal tear. | Positive PCR | Conservative management (aspirin, statins, and beta-blockers) |
Albiero [32] | 70/M | Smoking, hypertension, type 2 diabetes, prior PCI | Persistent severe chest pain | SCAD (LAD); moderate in-stent restenosis on LCx-OM and a moderate RCA stenosis. The culprit lesion was the proximal LAD that presented with a very complex and unusual plaque morphology, indicative of a coronary artery dissection. | Positive RT-PCR | PCI/discharged with: aspirin 100 mg/day, clopidogrel 75 mg/day, pantoprazole 40 mg/day, atorvastatin 40 mg/day, bisoprolol 1.25 mg/day, and metformin 850 mg three times a day. |
Fernandez Gasso [33] | 39/M | Unremarkable | Fever, cough, myalgia, oppressive chest pain, and dyspnea at rest | SCAD (LAD, OM): large and severe lumen narrowing in the first OM bordered by normal segments compatible with type 2A SCAD; moderate lumen narrowing in the distal LAD that extended to the end of the artery compatible with type 2B SCAD; a mild fistula between the proximal segment of the RCA and the pulmonary artery. | Positive nasopharyngeal and oropharyngeal swabs | Conservative therapy |
Abbreviations: LAD: left anterior descending, LCx: left circumflex artery, OM: obtuse marginal, PCI: percutaneous coronary intervention, PCR: polymerase chain reaction, RCA: right coronary artery, RT-PCR: real time polymerase chain reaction, SCAD: spontaneous coronary artery dissection