Heart and Vessels

, Volume 24, Issue 6, pp 463–465 | Cite as

Spontaneous coronary artery dissection: a review of the etiology and available treatment options

  • Andrew B. McCann
  • Robert J. Whitbourn
Case Report


Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction and sudden cardiac death. We present a case of a 36-year-old female runner who was successfully thrombolysed for acute anterior ST elevation myocardial infarction. Coronary angiography revealed spontaneous dissection of the left anterior descending and diagonal arteries. The patient was treated medically with warfarin and dual antiplatelet therapy. Repeat angiography at 8 weeks showed significant angiographic improvement. Exercise stress testing at 10 months was normal and allowed a return to exercise. At 28 months the patient is asymptomatic and fully active. A review of the etiology and available treatment options is presented.

Key words

Coronary artery disease Coronary angiography Aneurysm Dissection 


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  1. 1.
    Mohamed H, Eshawesh A, Habib N (2002) Spontaneous coronary artery dissection — a case report and review of the literature. Angiology 53:205–211CrossRefPubMedGoogle Scholar
  2. 2.
    Jorgensen MB, Aharonian V, Mansukhani P, Mahrer PR (1994) Spontaneous coronary dissection: a cluster of cases with this rare finding. Am Heart J 127:1382–1387CrossRefPubMedGoogle Scholar
  3. 3.
    Hering D, Piper C, Hohmann C, Schultheiss HP, Horstkotte D (1998) Prospective study of the incidence, pathogenesis and therapy of spontaneous, by coronary angiography diagnosed coronary artery dissection. Z Kardiol 87:961–970CrossRefPubMedGoogle Scholar
  4. 4.
    Thayer JO, Healy RW, Maggs PR (1987) Spontaneous coronary artery dissection. Ann Thorac Surg 44:97–102PubMedCrossRefGoogle Scholar
  5. 5.
    Kamineni R, Sadhu A, Alpert JS (2002) Spontaneous coronary artery dissection: report of two cases and a 50-year review of the literature. Cardiol Rev 10:279–284CrossRefPubMedGoogle Scholar
  6. 6.
    Maeder M, Amman P, Angehrn W, Rickli H (2005) Idiopathic spontaneous coronary dissection: incidence, diagnosis and treatment. Int J Cardiol 101:363–369CrossRefPubMedGoogle Scholar
  7. 7.
    Umman S, Olcay A, Sezer M, Erdogan D (2006) Exercise-induced coronary artery dissection treated with an anticoagulant and anti-aggregants. Anadolu Kardiyol Derg 6:385–386PubMedGoogle Scholar
  8. 8.
    Moukarbel GV, Alam SE (2004) Spontaneous coronary artery dissection: management options in the stent era. J Invasive Cardiol 16:333–335PubMedGoogle Scholar
  9. 9.
    Mori F, Tsurumi Y, Hagiwara N, Kasanuki H (2007) Impact of post-dilatation with a focal expanding balloon for optimization of intracoronary stenting. Heart Vessels 22:152–157CrossRefPubMedGoogle Scholar
  10. 10.
    Tanaka S, Watanabe S, Matsuo H, Segawa T, Iwama M, Hirose T, Takahashi H, Ono K, Warita S, Kojima T, Minatoguchi S, Fujiwara H (2008) Prospective randomized trial comparing a nitinol self-expanding coronary stent with low-pressure dilatation and a high-pressure balloon expandable bare metal stent. Heart Vessels 23:1–8CrossRefPubMedGoogle Scholar
  11. 11.
    Bocek P (2006) Idiopathic spontaneous coronary artery dissection and drug-eluting stents. Int J Cardiol 112:367CrossRefPubMedGoogle Scholar
  12. 12.
    Papafaklis MI, Katsouras CS, Theodorakis PE, Bourantas CV, Fotiadis DI, Michalis LK (2007) Coronary dilatation 10 weeks after paclitaxel-eluting stent implantation. No role of shear stress in lumen enlargement? Heart Vessels 22:268–273CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2009

Authors and Affiliations

  1. 1.Department of CardiologySt. Vincent’s HospitalFitzroy, Vic.Australia

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