Korean J Leg Med.  2025 May;49(2):51-55. 10.7580/kjlm.2025.49.2.51.

A Spontaneous Coronary Artery Dissection Autopsy in a 64-Year-Old Male

• Lee SW
• Jang W
• Kang TM
• Im SY
• Lee K
• Ko KS
• Choi J

• KMID: 2568274
• DOI: http://doi.org/10.7580/kjlm.2025.49.2.51

Abstract

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Keyword

Coronary artery dissection, spontaneous; Acute coronary syndrome; Death, sudden, cardiac; Autopsy