Spontaneous coronary dissection: case reports and literature review

Authors: Bockeria L.A. 1, Golukhova E.Z. 1, Petrosyan K.V. 1, Karaev A.V. 1, Grigoryan M.R. 2, V.V. Losev 1

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation
2 Pirogov Russian National Research Medical University Moscow, 117997, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/ 1997-3187-2020-14-1-71-81

For citation: Bockeria L.A., Golukhova E.Z., Petrosyan K.V., Karaev A.V., Grigoryan M.R., Losev V.V. Spontaneous coronary dissection: case reports and literature review. Creative Cardiology. 2020; 14 (1): 71–81 (in Russ.). DOI: 10.24022/1997-3187-2020-14-1-71-81

Received / Accepted:  14.03.2020 / 20.03.2020

Keywords: spontaneous coronary artery dissection percutaneous coronary intervention optical coherence tomography

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Abstract

Spontaneous coronary artery dissection (SDCA) is a relatively rare cause of acute coronary syndrome (ACS), not associated with atherosclerotic plaque. Currently, due to close monitoring and early invasive angiography in patients with complaints of severe chest pain, cases of SDCA are becoming more common. Seven cases of spontaneous coronary dissection were revealed in Bakoulev National Medical Research Center for Cardiovascular Surgery for the period from 2015 to 2019. The age of patients ranged from 43 to 58 (49.4 ± 5.0) years. In 3 patients, the clinic of SDCA was manifested by sternal pain; in 4 – SDCA cases were asymptomatic and were accidentally detected according to diagnostic coronary angiography. Of the 7 registered cases of SDCA, surgical myocardial revascularization was performed in 1 (14.3%) patient. In 2 (28.6%) cases – percutaneous coronary intervention with stenting of the affected vessel with the coating of the entire zone of SDCA with a metal frame of the stent was performed. And in 4 (57.1%) patients – self-healing of coronary artery was noted in the period from 2 to 5 (3.8 ± 1.1) month. Spontaneous coronary artery dissection is a very significant cause of the development of the acute coronary syndrome and sudden death syndrome in women under the age of 50 years. It is important to understand that pathophysiology and, as a result, the treatment of SDCA differ from ACS associated with the rupture of an atherosclerotic plaque.

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About Authors

Leo A. Bockeria, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, President, ORCID
Elena Z. Golukhova, Dr. Med. Sc., Professor, Academician of Russian Academy of Sciences, SPIN: 9334-5672, ORCID
Karen V. Petrosyan, Cand. Med. Sc., Head of Department, ORCID
Aslan V. Karaev, Junior Researcher, ORCID
Marietta R. Grigoryan, Student, ORCID
Vladimir V. Losev, Postgraduate, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery