Spontaneous Coronary Artery Dissection in a Male Patient With Fibromuscular Dysplasia

Overview

Journal Tex Heart Inst J

Specialty Cardiology & Vascular Diseases

Date 2024 May 9

PMID 38722191

Authors

Artur Schneider

S Michael Gharacholou

Affiliations

Soon will be listed here.

Abstract

A male patient presented with cardiac arrest attributed to anterior ST-segment elevation myocardial infarction from type 1 spontaneous coronary artery dissection. Subsequent imaging confirmed fibromuscular dysplasia in noncoronary arterial segments. The patient was started on guideline-directed medical therapy and referred to cardiac rehabilitation, showing substantial improvements in clinical status. With greater awareness and advancements in imaging, spontaneous coronary artery dissection has been more frequently recognized, and although as many as 81% to 92% of all cases occur in female patients, it can be seen among men, as well. Adjunctive imaging for arteriopathies may help establish the diagnosis for equivocal causes of acute coronary syndrome in women and men.

References

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

Shufelt C, Pacheco C, Tweet M, Miller V . Sex-Specific Physiology and Cardiovascular Disease. Adv Exp Med Biol. 2018; 1065:433-454. PMC: 6768431. DOI: 10.1007/978-3-319-77932-4_27. View

Saw J, Humphries K, Aymong E, Sedlak T, Prakash R, Starovoytov A . Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence. J Am Coll Cardiol. 2017; 70(9):1148-1158. DOI: 10.1016/j.jacc.2017.06.053. View

Jia S, Liu Y, Yuan J . Evidence in Guidelines for Treatment of Coronary Artery Disease. Adv Exp Med Biol. 2020; 1177:37-73. DOI: 10.1007/978-981-15-2517-9_2. View

Desai S, Sheppard M . Sudden cardiac death: look closely at the coronaries for spontaneous dissection which can be missed. A study of 9 cases. Am J Forensic Med Pathol. 2012; 33(1):26-9. DOI: 10.1097/paf.0b013e3181e29598. View

Saw J, Mancini G, Humphries K, Fung A, Boone R, Starovoytov A . Angiographic appearance of spontaneous coronary artery dissection with intramural hematoma proven on intracoronary imaging. Catheter Cardiovasc Interv. 2015; 87(2):E54-61. DOI: 10.1002/ccd.26022. View

Georges A, Yang M, Berrandou T, Bakker M, Dikilitas O, Kiando S . Genetic investigation of fibromuscular dysplasia identifies risk loci and shared genetics with common cardiovascular diseases. Nat Commun. 2021; 12(1):6031. PMC: 8521585. DOI: 10.1038/s41467-021-26174-2. View

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

Main A, Saw J . Percutaneous Coronary Intervention for the Treatment of Spontaneous Coronary Artery Dissection. Interv Cardiol Clin. 2019; 8(2):199-208. DOI: 10.1016/j.iccl.2018.11.008. View

10.

Khoury M, Gornik H . Fibromuscular dysplasia (FMD). Vasc Med. 2017; 22(3):248-252. DOI: 10.1177/1358863X17700716. View

11.

Gulati R, Behfar A, Narula J, Kanwar A, Lerman A, Cooper L . Acute Myocardial Infarction in Young Individuals. Mayo Clin Proc. 2020; 95(1):136-156. DOI: 10.1016/j.mayocp.2019.05.001. View

12.

Kwon T, Gulati R, Matsuzawa Y, Aoki T, Guddeti R, Herrmann J . Proliferation of Coronary Adventitial Vasa Vasorum in Patients With Spontaneous Coronary Artery Dissection. JACC Cardiovasc Imaging. 2016; 9(7):891-892. DOI: 10.1016/j.jcmg.2015.11.030. View

13.

Pristera N, Chaudhury P, Van Iterson E, Cho L . Spontaneous coronary artery dissection: Principles of management. Cleve Clin J Med. 2021; 88(11):623-630. DOI: 10.3949/ccjm.88a.20162. View

14.

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

15.

Elkayam U, Jalnapurkar S, Barakkat M, Khatri N, Kealey A, Mehra A . Pregnancy-associated acute myocardial infarction: a review of contemporary experience in 150 cases between 2006 and 2011. Circulation. 2014; 129(16):1695-702. DOI: 10.1161/CIRCULATIONAHA.113.002054. View

16.

Adlam D, Alfonso F, Maas A, Vrints C . European Society of Cardiology, acute cardiovascular care association, SCAD study group: a position paper on spontaneous coronary artery dissection. Eur Heart J. 2018; 39(36):3353-3368. PMC: 6148526. DOI: 10.1093/eurheartj/ehy080. View