Spontaneous left main coronary artery dissection complicated with vasospasm

CASE PRESENTATION We present the case of a 36-year-old female (informed consent obtained) with a past medical history of childbirth 2 months before being admitted to the emergency room with signs of chest pain with irradiation to her left arm associated with diaphoresis and dyspnea with 1-hour evolu...

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Autores principales:	Cátia Costa Oliveira, Carlos Galvão Braga, Catarina Quina, João Costa, Jorge Marques
Formato:	article
Lenguaje:	EN ES
Publicado:	Permanyer 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/2cae5a1f9cf84d039bdd1494e4739422
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spelling	oai:doaj.org-article:2cae5a1f9cf84d039bdd1494e47394222021-11-08T09:18:11ZSpontaneous left main coronary artery dissection complicated with vasospasm10.24875/RECICE.M200001932604-7322https://doaj.org/article/2cae5a1f9cf84d039bdd1494e47394222021-11-01T00:00:00Zhttps://recintervcardiol.org/en/index.php?option=com_content&view=article&id=612https://doaj.org/toc/2604-7322CASE PRESENTATION We present the case of a 36-year-old female (informed consent obtained) with a past medical history of childbirth 2 months before being admitted to the emergency room with signs of chest pain with irradiation to her left arm associated with diaphoresis and dyspnea with 1-hour evolution. The electrocardiogram (ECG) performed did not show any alterations, but the blood test confirmed the presence of increased myocardial necrosis markers (troponin I, 1.9 ng/mL; normal < 0.045 ng/mL). The serial ECGs performed revealed progressive alterations, namely T-wave inversion in leads I, aVL, and V1-V3. The transthoracic echocardiogram showed good systolic left ventricular function without wall motion alterations. The patient underwent a coronary angiography that revealed an image suggestive of intramural hematoma conditioning a diffuse stenosis of the left main (LMCA) and proximal left anterior descending (LAD) coronary arteries (video 1 of the supplementary data; figure 1A). Due to the patient’s high-risk coronary anatomy, it was decided to repeat the coronary angiography 8 days later. However, after cannulating the LMCA (6-Fr JL 3.5), a sudden reduction of the distal LMCA and proximal LAD flow was seen (probable vasospasm) (video 2 of the supplementary data; figure 1B). Consequently, the guidewire was crossed to the...Cátia Costa OliveiraCarlos Galvão BragaCatarina QuinaJoão CostaJorge MarquesPermanyerarticleMedicineRENESREC: Interventional Cardiology (English Ed.), Vol 3, Iss 4, Pp 321-322 (2021)
institution	DOAJ
collection	DOAJ
language	EN ES
topic	Medicine R
spellingShingle	Medicine R Cátia Costa Oliveira Carlos Galvão Braga Catarina Quina João Costa Jorge Marques Spontaneous left main coronary artery dissection complicated with vasospasm
description	CASE PRESENTATION We present the case of a 36-year-old female (informed consent obtained) with a past medical history of childbirth 2 months before being admitted to the emergency room with signs of chest pain with irradiation to her left arm associated with diaphoresis and dyspnea with 1-hour evolution. The electrocardiogram (ECG) performed did not show any alterations, but the blood test confirmed the presence of increased myocardial necrosis markers (troponin I, 1.9 ng/mL; normal < 0.045 ng/mL). The serial ECGs performed revealed progressive alterations, namely T-wave inversion in leads I, aVL, and V1-V3. The transthoracic echocardiogram showed good systolic left ventricular function without wall motion alterations. The patient underwent a coronary angiography that revealed an image suggestive of intramural hematoma conditioning a diffuse stenosis of the left main (LMCA) and proximal left anterior descending (LAD) coronary arteries (video 1 of the supplementary data; figure 1A). Due to the patient’s high-risk coronary anatomy, it was decided to repeat the coronary angiography 8 days later. However, after cannulating the LMCA (6-Fr JL 3.5), a sudden reduction of the distal LMCA and proximal LAD flow was seen (probable vasospasm) (video 2 of the supplementary data; figure 1B). Consequently, the guidewire was crossed to the...
format	article
author	Cátia Costa Oliveira Carlos Galvão Braga Catarina Quina João Costa Jorge Marques
author_facet	Cátia Costa Oliveira Carlos Galvão Braga Catarina Quina João Costa Jorge Marques
author_sort	Cátia Costa Oliveira
title	Spontaneous left main coronary artery dissection complicated with vasospasm
title_short	Spontaneous left main coronary artery dissection complicated with vasospasm
title_full	Spontaneous left main coronary artery dissection complicated with vasospasm
title_fullStr	Spontaneous left main coronary artery dissection complicated with vasospasm
title_full_unstemmed	Spontaneous left main coronary artery dissection complicated with vasospasm
title_sort	spontaneous left main coronary artery dissection complicated with vasospasm
publisher	Permanyer
publishDate	2021
url	https://doaj.org/article/2cae5a1f9cf84d039bdd1494e4739422
work_keys_str_mv	AT catiacostaoliveira spontaneousleftmaincoronaryarterydissectioncomplicatedwithvasospasm AT carlosgalvaobraga spontaneousleftmaincoronaryarterydissectioncomplicatedwithvasospasm AT catarinaquina spontaneousleftmaincoronaryarterydissectioncomplicatedwithvasospasm AT joaocosta spontaneousleftmaincoronaryarterydissectioncomplicatedwithvasospasm AT jorgemarques spontaneousleftmaincoronaryarterydissectioncomplicatedwithvasospasm
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Spontaneous left main coronary artery dissection complicated with vasospasm

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