Spontaneous coronary artery dissection as a cause of ST-segment elevation myocardial infarction: a clinical case report
DOI:
https://doi.org/10.37711/rpcs.2026.8.1.8Keywords:
cardiomyopathies, myocardial infarction, myocardium, ST elevation myocardial infarction, coronary circulationAbstract
Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome, accounting for 1% to 4% of cases; it mainly affects young women without traditional coronary risk factors. This case highlights the importance of considering it as a differential diagnosis in patients with acute ST-segment elevation myocardial infarction. After informed consent was obtained, we report the case of a 45-year-old woman with no history of cardiovascular disease who presented to the Emergency Department with pressure-like chest pain radiating to the jaw. The electrocardiogram showed ST-segment elevation in the anterolateral leads. Cardiac biomarkers revealed significantly elevated troponin and CK-MB levels. Coronary angiography showed proximal dissection of the left anterior descending artery with thrombus in the proximal and mid segments, confirming the diagnosis. Distal TIMI grade III flow was documented; therefore, conservative management was chosen with single antiplatelet therapy (ASA 100 mg), a beta-blocker (metoprolol 50 mg), and statin therapy (atorvastatin 80 mg). The patient had a favorable clinical course after 10 days of hospitalization. Spontaneous coronary artery dissection should be suspected in young women with acute myocardial infarction and no traditional coronary risk factors. Early diagnosis and appropriate management are essential to reduce complications and improve prognosis.
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Copyright (c) 2026 Daniel Botero Cubides , Laura Salinas Muñoz , Edgar Fabian Manrique Hernández , Gianmarco Camelo Pardo , Karol Macias Quiñonez
This work is licensed under a Creative Commons Attribution 4.0 International License.
