Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Spontaneous Coronary Artery Dissection Mimicking Coronary Spasm Diagnosed by Intravascular Ultrasonography

  • Chung, Hyemoon (Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Sung-Joo (Cardiology Division, Department of Internal Medicine, Chungju Medical Center) ;
  • Park, Jong-Kwan (Cardiology Division, Department of Internal Medicine, NHIC Ilsan Hospital) ;
  • Choi, In Suk (Cardiology Division, Department of Internal Medicine, Gachon University) ;
  • Won, Ho Yeon (Cardiology Division, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Sohee (Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Cha, Jung-Joon (Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Byoung Kwon (Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Published : 2013.07.30
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Abstract

Spontaneous coronary artery dissection (SCAD) is a rare and occasionally life-threatening cause of acute coronary syndrome. Patients may present with clinical scenarios ranging from angina pectoris to cardiogenic shock to sudden cardiac death, and it may be a potentially life-threatening condition if not recognized. However, its etiology, pathophysiology and optimal therapeutic strategies have not been well understood. SCAD is diagnosed on the basis of coronary angiography, but complementary techniques as such intravascular ultrasound (IVUS) and optical coherence tomography should be considered for diagnostic clarification where appropriate. Likewise, the selection of treatment strategy depends upon the clinical manifestation, location and the extent of dissection and amount of ischemic myocardium at risk. Herein, we present the case of a 35-year-old woman who presented with acute myocardial infarction. She was diagnosed by IVUS with spontaneous diffuse dissection of the left anterior descending artery without atheroma, treated with percutaneous coronary stenting, and had a favorable clinical course and was discharged on medical therapy.

Keywords

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