Spontaneous Coronary Artery Dissection: Presentation of Thre
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Introduction :
Spontaneous (not iatrogenic) coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes (ACS), including cardiogenic shock and sudden cardiac death. Except common atherosclerosis, peripartum period is a documented predisposing factor, as well as arteritis, usually as a result of auto-immune response. This diagnosis is typically presented in a diagnostic coronary angiography. All therapeutic options are acceptable, mainly percutaneous coronary intervention (PCI) but also drug therapy and surgical treatment. We present three cases of SCAD at our institution, with a short review of the literature.

Case :
A 54 year-old female with no previous history of heart disease and no risk factors for coronary artery disease, was transferred to our hospital from a peripheral Health Center due to acute anterior myocardial infarction (STEMI). Angina occurred 2 hours after her participation in a Marathon race. Coronary angiography revealed SCAD of distal LAD with TIMI-II peripheral flow (Figure 1). Direct stenting was performed, with good angiographic result. Four days later, the patient was discharged after a mild elevation of cardiac enzymes and an uncomplicated clinical course. She is asymptomatic, two years after the acute coronary syndrome.......