Spontaneous coronary artery dissection as a cause of acute myocardial infarction with ST elevation

Introduction. Spontaneous coronary artery dissection (SCAD) is defined as a that has not occurred with atherosclerosis, trauma, or developed iatrogenically. Case outline. A 53-year-old man was admitted to the hospital due chest pain and ischemic electrocardiographical changes. Coronarography performed 85% of stenosis first diagonal branch (D1) registered. During percutaneous intervention (PCI), one drug-eluting directly implanted into D1. About three hours after intervention, patient an acute myocardial infarction ST elevation (STEMI) recoronarography performed. The previously stent in D1 patent without thrombi. subocclusive left anterior descending (LAD) registered PCI After implantation stents LAD, propagation towards circumflex (LCx) creating significant stenosis. Following registration stenosis, on this branch. In order determine cause STEMI, intravascular imaging performed, seven days last PCI. Optical coherence tomography showed excellent apposition expansion. area under stents, proximal segment LAD LCx, duplication blood vessel wall. This represents unresorbed intramural hematoma consequence SCAD. Conclusion. When performing coronarography younger patients, women peripartum patients connective tissue, SCAD disorders should be kept mind. use could reduce number unrecognized