Abstract:

Objective To explore the clinical characteristics of spontaneous coronary artery dissection, aiming to improve the diagnosis and treatment of this disease. Methods The clinical data of a young female patient with acute myocardial infarction caused by spontaneous coronary artery dissection were retrospectively analyzed. In addition, relevant Chinese and English language literatures were searched in the CNKI, PubMed and Wanfang databases using the keywords of “spontaneous coronary artery dissection”, “acute myocardial infarction” and “young female” to perform literature review. Results A 35-year-old young woman presented in our hospital with an intermittent chest pain. Electrocardiography showed ST-segment elevation in leads I, aVL and V2-V5. Troponin T was elevated (>2 000 ng/L). Coronary angiography (CAG) showed that the left main stem (LM) was dissected from the opening, which was extended to the distal segment of the left anterior descending branch (LAD) and the middle part of the left circumflex branch (LCX). The lumen was under pressure throughout the whole process, and the proximal vessels were unable to be visualized. Percutaneous coronary intervention (PCI) was performed under the guidance of intravenous ultrasound (IVUS). At the 1-month follow-up visit, CAG showed a good therapeutic effect. Conclusion Spontaneous coronary dissection is a rare cause of acute coronary syndrome, and its disease characteristics and treatment methods are different from those of coronary atherosclerosis. The diagnosis is challenging and it is easy to be misdiagnosed and mistreated clinically. Therefore, the possibility of spontaneous coronary dissection should be considered in young patients with ACS.

Key words: aneurysm, dissecting, young women, myocardial infarction