SPONTANEOUS CORONARY ARTERY DISSECTION LEADING TO ACUTE MYOCARDIAL INFARCTION AND REDUCED LEFT VENTRICULAR EJECTION FRACTION IN AN OTHERWISE HEALTHY FEMALE: CASE REPORT AND BRIEF REVIEW OF THE LITTERATURE.

Abstract

In the following case a 46-year old non-smoking and healthywoman, with no previous coronary risk factors, was admitted at the department of cardiology at the regional university hospital following sudden onset of severe substernal chest pressure not associated with dyspnea or palpitations. The patient’s electrocardiogram (ECG) revealed ST-segment elevation in the anterior leads. Bedside echocardiography showed anterior wallhypokinesis with a 40 – 45 % left ventricular ejection fraction (LVEF).  Acute coronary angiography demonstrated dissection of the left anterior descending coronary artery (LAD) with associated intracoronary thrombus. The other coronary arteries were normal.A 2.5 x 28 mm Xience stent was deployed to cover the entire dissection and the patient tolerated the procedure without any significant complications and was discharged from the hospitalfour days later. The patient was asymptomatic on follow-up at 1 and 3 months.