Korean Circ J.  2011 Jun;41(6):346-348. 10.4070/kcj.2011.41.6.346.

A Case of Spontaneous Coronary Artery Dissection Healed by Medical Treatment: Serial Findings of Coronary Angiography, Intravascular Ultrasound and Multi-Detector Computed Tomography

• Koh JS
• Jeong YH
• Yoon SE
• Park JR
• Park Y
• Hwang SJ
• Kwak CH
• Hwang JY

• KMID: 1776195
• DOI: http://doi.org/10.4070/kcj.2011.41.6.346

Abstract

Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome which may be related to lethal condition. Although several modalities including medical therapy have been suggested, agreement on optimal treatment has not yet been determined. We describe a case of SCAD which was presented as ST-segment elevation myocardial infarction, and treated successfully with medical treatment. Coronary angiography, intravascular ultrasound and multi-detector computed tomography showed the serial changes of this disease entity.

Keyword

Coronary artery disease; Dissection; Myocardial infarction; Angiography; Ultrasonography, interventional; Tomography, spiral computed

MeSH Terms

Acute Coronary Syndrome
Angiography
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Myocardial Infarction
Tomography, Spiral Computed
Ultrasonography, Interventional

Figure

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  Fig. 1 Serial findings of coronary angiography (CAG) and intravascular ultrasound (IVUS) of distal left anterior descending artery (LAD). A: initial CAG showed a long and smooth lesion from the mid to distal LAD which was abruptly transitted from the proximal LAD. B: follow-up CAG revealed improved state of distal LAD. C: in the initial IVUS. The huge extramural hematoma compressing the true lumen of distal LAD. D: follow-up IVUS revealed resolved hematoma of distal LAD.

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  Fig. 2 Serial findings of multi-detector computed tomography (MDCT) of distal left anterior descending artery (LAD). A and B: initial MDCT manifest compressing extramural hematoma and narrowed true lumen of distal LAD. C and D: follow-up MDCT revealed disappeared hematoma and normal luminal diameter of distal LAD.

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