Chronic Spontaneous Coronary Artery Dissection in Association with Antiphospholipid Syndrome Presenting As Stable Angina

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2019 Mar 16

PMID 30872339

Citations 3

Authors

Napohn Chongprasertpon

Abdalla Ibrahim

Michael Goggins

Thomas Kiernan

Affiliations

Soon will be listed here.

Abstract

A 52-year-old man presented to our cardiology service for an elective diagnostic coronary angiogram for risk stratification in the context of stable angina. He was diagnosed with antiphospholipid syndrome 2 years prior and had three known thrombotic episodes in the form of a stroke, retinal artery occlusion and deep vein thrombosis. Our initial differential was atherosclerotic coronary artery disease, however, coronary angiography demonstrated a dominant right coronary artery with a long segment of chronic spontaneous dissection distally but with thrombolysis in myocardial infarction III flow. He was treated medically with antianginals which rendered him asymptomatic and is currently on regular follow-up in the cardiology outpatient department.

Citing Articles

Arterial Dissection in Antiphospholipid Syndrome Patients: Two Case Reports and a Literature Review.

Al-Banaa K, Alshaikhli A, Al-Hareeri A, Abdelhalim M, Al-Hillan A, Joshi T Eur J Case Rep Intern Med. 2021; 8(5):002610.

PMID: 34123952 PMC: 8191364. DOI: 10.12890/2021_002610.

Lack of Association of Spontaneous Coronary Artery Dissection With Autoimmune Disease.

Kronzer V, Tarabochia A, Lobo Romero A, Tan N, OByrne T, Crowson C J Am Coll Cardiol. 2020; 76(19):2226-2234.

PMID: 33153582 PMC: 7788566. DOI: 10.1016/j.jacc.2020.09.533.

Spontaneous coronary artery dissection in systemic lupus erythematosus: case-based review.

Alvarez-Lario B, Alvarez-Roy L, Mayordomo-Gomez S, Garcia-Garcia J Rheumatol Int. 2019; 39(10):1821-1827.

PMID: 31227856 DOI: 10.1007/s00296-019-04351-3.

References

Saw J, Aymong E, Sedlak T, Buller C, Starovoytov A, Ricci D . Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv. 2014; 7(5):645-55. DOI: 10.1161/CIRCINTERVENTIONS.114.001760. View

Saw J . Pregnancy-Associated Spontaneous Coronary Artery Dissection Represents an Exceptionally High-Risk Spontaneous Coronary Artery Dissection Cohort. Circ Cardiovasc Interv. 2017; 10(3). DOI: 10.1161/CIRCINTERVENTIONS.117.005119. View

Gerede D, Yuksel B, Tutar E, Kucuksahin O, Uzun C, Atasoy K . Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu's Arteritis and Antiphospholipid Antibody Syndrome. Case Rep Rheumatol. 2013; 2013:272963. PMC: 3727182. DOI: 10.1155/2013/272963. View

Rogowski S, Maeder M, Weilenmann D, Haager P, Ammann P, Rohner F . Spontaneous Coronary Artery Dissection: Angiographic Follow-Up and Long-Term Clinical Outcome in a Predominantly Medically Treated Population. Catheter Cardiovasc Interv. 2015; 89(1):59-68. DOI: 10.1002/ccd.26383. View

Yip A, Saw J . Spontaneous coronary artery dissection-A review. Cardiovasc Diagn Ther. 2015; 5(1):37-48. PMC: 4329168. DOI: 10.3978/j.issn.2223-3652.2015.01.08. View

Reddy S, Vaid T, Ganiga Sanjeeva N, Shetty R . Spontaneous coronary artery dissection as the first presentation of systemic lupus erythematosus. BMJ Case Rep. 2016; 2016. PMC: 5015165. DOI: 10.1136/bcr-2016-216344. View

Tweet M, Eleid M, Best P, Lennon R, Lerman A, Rihal C . Spontaneous coronary artery dissection: revascularization versus conservative therapy. Circ Cardiovasc Interv. 2014; 7(6):777-86. DOI: 10.1161/CIRCINTERVENTIONS.114.001659. View

Lempereur M, Fung A, Saw J . Stent mal-apposition with resorption of intramural hematoma with spontaneous coronary artery dissection. Cardiovasc Diagn Ther. 2015; 5(4):323-9. PMC: 4536472. DOI: 10.3978/j.issn.2223-3652.2015.04.05. View

Saw J . Coronary angiogram classification of spontaneous coronary artery dissection. Catheter Cardiovasc Interv. 2013; 84(7):1115-22. DOI: 10.1002/ccd.25293. View

10.

Persu A, Giavarini A, Touze E, Januszewicz A, Sapoval M, Azizi M . European consensus on the diagnosis and management of fibromuscular dysplasia. J Hypertens. 2014; 32(7):1367-78. DOI: 10.1097/HJH.0000000000000213. View

11.

Hill S, Sheppard M . Non-atherosclerotic coronary artery disease associated with sudden cardiac death. Heart. 2010; 96(14):1119-25. DOI: 10.1136/hrt.2009.185157. View

12.

Bonnet J, Aumailley M, Thomas D, Grosgogeat Y, Broustet J, BRICAUD H . Spontaneous coronary artery dissection: case report and evidence for a defect in collagen metabolism. Eur Heart J. 1986; 7(10):904-9. DOI: 10.1093/oxfordjournals.eurheartj.a061979. View

13.

Lettieri C, Zavalloni D, Rossini R, Morici N, Ettori F, Leonzi O . Management and Long-Term Prognosis of Spontaneous Coronary Artery Dissection. Am J Cardiol. 2015; 116(1):66-73. DOI: 10.1016/j.amjcard.2015.03.039. View

14.

Saw J, Mancini G, Humphries K . Contemporary Review on Spontaneous Coronary Artery Dissection. J Am Coll Cardiol. 2016; 68(3):297-312. DOI: 10.1016/j.jacc.2016.05.034. View

15.

Jneid H, Wright R, Adams C, Bridges C, Casey Jr D, Ettinger S . 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/Non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 focused update): a report of the American College of.... Circulation. 2012; 126(7):875-910. DOI: 10.1161/CIR.0b013e318256f1e0. View

16.

Abdullah A, Ibrahim H, Kiernan T . Spontaneous coronary artery dissection: a complete resolution with medical treatment. BMJ Case Rep. 2014; 2014. PMC: 4202080. DOI: 10.1136/bcr-2014-204153. View

17.

Alfonso F, Paulo M, Gonzalo N, Dutary J, Jimenez-Quevedo P, Lennie V . Diagnosis of spontaneous coronary artery dissection by optical coherence tomography. J Am Coll Cardiol. 2012; 59(12):1073-9. DOI: 10.1016/j.jacc.2011.08.082. View

18.

Bittl J, Ryan Jr T, Keaney Jr J, Tcheng J, ELLIS S, Isner J . Coronary artery perforation during excimer laser coronary angioplasty. The percutaneous Excimer Laser Coronary Angioplasty Registry. J Am Coll Cardiol. 1993; 21(5):1158-65. DOI: 10.1016/0735-1097(93)90240-2. View

19.

Kothari D, Ruygrok P, Gentles T, Occleshaw C . Spontaneous coronary artery dissection in an adolescent man with systemic lupus erythematosus. Intern Med J. 2007; 37(5):342-3. DOI: 10.1111/j.1445-5994.2007.01345.x. View

20.

LeBrun S, Bond R . Spontaneous coronary artery dissection (SCAD): The underdiagnosed cardiac condition that plagues women. Trends Cardiovasc Med. 2017; 28(5):340-345. DOI: 10.1016/j.tcm.2017.12.004. View