Spontaneous Left Main Coronary Artery Dissection Presenting with Acute Myocardial Infarction in an Elderly Male: A Clue from the Collateral Flow

authors:

avatar Sung Woo Cho ORCID 1 , avatar Byung Gyu Kim 1 , avatar Jong Chun Nah ORCID 1 , *

Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea
International Cardiovascular Research Journal: Vol.13, issue 2; 75-77
published online: June 30, 2019
article type: Case Report
received: June 19, 2018
accepted: March 11, 2019

how to cite: Cho S W, Kim B G , Nah J C. Spontaneous Left Main Coronary Artery Dissection Presenting with Acute Myocardial Infarction in an Elderly Male: A Clue from the Collateral Flow. Int Cardiovasc Res J. 2019;13(2):e83466. 

Abstract

Spontaneous Coronary Artery Dissection (SCAD) is a rare cause of Acute Myocardial Infarction (AMI), which usually occurs in young or middle-aged healthy females. Here, we reported a 62-year-old male having SCAD in the Left Main Coronary Artery (LMCA) presenting with AMI. In this case, we could diagnose a spontaneous LMCA dissection with the help of contrast dye staining at the end of the collateral flow from the Right Coronary Artery (RCA). Even a small amount of contrast dye staining at the end of the collateral flow from the RCA provides an important clue for suspecting spontaneous LMCA dissection. Meticulous catheter manipulation should be required in such cases to prevent the extension of iatrogenic catheter-dissection during the procedure.

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Video 1. Right Coronary Angiography Showing a Collateral Flow toward the Left Anterior Descending Artery and Contrast Dye Staining at the End of the Collateral Flow, Which Was Suspicious of Spontaneous Left Main Coronary Artery Dissection.

Video 1: https://neoscriber.org/cdn/serve/314b2/891414b033302e67bf3053196b5a7ea6115516c9/Movie%20S1.avi

Video 2. Intravascular Ultrasound Showing a Soft Atherosclerotic Plaque at the Proximal Left Anterior Descending Artery and a Dissection Flap and False Lumen with Intramural Hematoma at the Left Main Coronary Artery.

 

Video 2: https://neoscriber.org/cdn/serve/314b2/540c0f4038c5eeea1d48a395245402e8509787c5/Movie%20S2.avi

 

References

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