Spontaneous coronary artery dissection is a rare diagnosis in a postmenopausal woman. We report a case of a 55-year-old postmenopausal woman, who presented with acute myocardial infarction due to spontaneous long dissection of left anterior descending coronary artery, complicated with repetitive ventricular tachycardia, rapid formation of left ventricular aneurysm with thrombus, pulmonary edema and cardiogenic shock, with subsequent improvement after successful angioplasty and intensive care. We also present a short review of the literature.
Key words: coronary artery, spontaneous dissection, acute myocardial infarction.
ACS = acute coronary syndrome;
AMI = acute myocardial infarction;
BMSs = bare-metal stents;
bpm = beats per minute;
CAGB = coronary artery bypass grafting;
CV = cardiovascular;
ECG = electrocardiogram;
LAD = left anterior descending coronary artery;
LVEF = left ventricle ejection fraction;
PCI = percutaneous coronary intervention;
SCAD = Spontaneous coronary artery disease;
Spontaneous coronary artery dissection (SCAD), a non-traumatic and non-iatrogenic separation of the coronary wall1, is a rare yet increasingly recognized cause of acute coronary syndrome, especially in younger female patients without traditional vascular risk factors2. Since its first description in 19313 more cases are now identified due to increased awareness and earlier use of angiography4. Despite that, the pathophysiology of SCAD remains poorly understood5-8, the clinical features and prognosis are insufficiently characterized and the management of patients remains highly controversial5. It is important to recognize SCAD, as patient characteristics and management differ from typical ACS.