Login subscribe free e-newsletter/product bulletins journal of invasive cardiology follow us on home about/contact subscribe issues current issue issue archives editor's update advertise reprints authors author instructions submission portal reviewers search search all cardiology websites search www. Invasivecardiology. Com search www. Cathlabdigest. Com search www. Eplabdigest. Com search www. Vasculardiseasemanagement. Com june, 2004 spontaneous coronary artery dissection: management options in the stent era fri, 8/1/08 - 12:12pm 0 comments 5503 reads author(s): george v. Moukarbel, md and samir e. Alam, md abstract: spontaneous coronary artery dissection (scad) is a rare cause of coronary obstruction, usually affecting women in the childbearing age. Pathogenetic mechanisms are elusive, and optimal treatment is not established. We describe a case of spontaneous coronary artery dissection that was successfully treated by coronary stenting. The published literature regarding the outcome of this modality of treatment in patients with scad is reviewed. A patient with spontaneous coronary artery dissection treated by stenting is described along with a review of the published literature regarding treatment of similar patients. J invas cardiol 2004;16:333â€“335 key words: coronary artery, dissection, stent spontaneous coronary artery dissection (scad) is a rare cause of acute coronary obstruction. 1 prompt recognition is crucial for appropriate patient management. We describe the occurrence of scad in a peri-menopausal woman that was successfully treated by emergency stenting. We also review the relevant literature with regard to management of this condition. Case report. A 52-year-old lady presented to the emergency room with acute onset oppressive retrosternal chest pain of half hour duration. On examination, she was in severe pain. She had a blood pressure of 140/80 mmhg and a regular pulse of 95 bpm. Her electrocardiogram (ecg) showed st elevations in leads ii, iii and avf with st depressions in the lateral leads. Echocardiography revealed akinesia of the inferior wall with preserved overall systolic function. She was mildly dyslipidemic with no other risk factors for coronary atherosclrerosis. She was given aspirin, cardinal mg of clopidogrel and heparin. Thrombolytic therapy with 6000 units of tenecteplase (metalyseâ®) intravenous bolus was administered.
Pain and ecg changes improved, but recurred 45 minutes later. She was urgently transferred to the catheterization laboratory for r.
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