Succesful treatment of spontaneous dissection of the coronary artery by primary percutaneous coronary intervention

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction. The disease is usually seen in young-middle aged women and leads to sudden death in the majority of cases. In survived patients, diagnosis of SCAD has been made with coronary anjiography. Involvement of left main coronary artery (LMCA) is very unusual. We describe on a case of SCAD involving the LMCA in a young woman presenting with an acute myocardial infarction and cardiogenic shock status. There were no risk factors for coronary artery disease and no evidence of atherosclerosis on angiography. Coronary angiography revealed dissection of the LMCA that extended into the anterior descending and circumflex coronary arteries. The dissection was successfully treated with primary coronary artery stenting. The patient was discharged without complication. There was no problem in the first evaluation at the end of the first of the month.

Keywords

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Spontan koroner arter diseksiyonuna bağlı akut miyokard infarktüsünün primer perkütan girişimle başarılı tedavisi

Öz

Spontan koroner arter diseksiyonu, akut miyokard infarktüsünün nadir rastlanan bir nedenidir. Hastalık genellikle genç-orta yaştaki kadınlarda görülür. Spontan koroner arter diseksiyonu olguların büyük kısmında ani kardiyak ölüme neden olur. Yaşayan hastalarda hastalığın tanısı koroner anjiyografi ile konur. Hastalık en sık sol ön inen koroner arteri tutar, sol ana koroner arterin tutulumu ise son derece nadirdir. Biz sol ana koroner arterin spontan diseksiyonuna bağlı akut miyokard infarktüsü ve kardiyojenik şok tablosunda başvuran genç bir kadın hastayı bildirdik. Hastanın koroner arter hastalığı için risk faktörü yoktu. Koroner anjiyografisi sol ön inen koroner artere ve sirkumfleks artere uzanan sol ana koroner arter diseksiyonunu gösterdi. Anjiyografide ateroskleroza ait bulgu saptanmadı. Koroner diseksiyon, primer perkütan koroner girişim ile stentlenerek tedavi edildi. Hasta herhangi bir komplikasyon olmaksızın taburcu edildi ve birinci ayın sonundaki kontrolde sorunsuzdu.

Anahtar Kelimeler

• Akut miyokard infarktüsü, spontan koroner arter diseksiyonu, stent

Kaynakça

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