• J Invasive Cardiol · Sep 2012

    Case Reports

    Spontaneous coronary artery dissection in an elderly woman presenting with chest pain and positive cardiac biomarkers.

    • Mohanad A Alfaqih, Rosa M Michel Ortega, and Eric H Yang.
    • Henry Ford Hospital, Department of Internal Medicine, Division of Cardiovascular Disease, Detroit, Michigan 48202, USA.
    • J Invasive Cardiol. 2012 Sep 1; 24 (9): E193-5.

    AbstractA 68-year-old African American female with a prior medical history of hypertension and dyslipidemia presented with sudden onset pressure-like substernal chest pain. Initial ECG showed no ST or T wave abnormalities, and troponin elevation of 2.88 ng/mL. Two hours later, chest pain recurred with ECG change and increase in troponin to 11.97 ng/mL. She underwent urgent coronary angiography, which revealed left anterior descending artery dissection with thrombus. We successfully treated with balloon angioplasty followed by placement of 3 drug-eluting stents resulting in TIMI-3 flow; further testing for vasculitis was negative. Once spontaneous coronary artery dissection is diagnosed, the approach to treatment is controversial and treatment should be patient tailored.

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