FOLLOW-UP AFTER SPONTANEOUS CORONARY-ARTERY DISSECTION - A REPORT OF 5 CASES

Five cases of spontaneous coronary artery dissection (SCAD) are report ed, three in women and two in men (mean age 44 years; range 28-65), al l of whom suffered a myocardial infarction. Common risk factors for co ronary artery disease were present in the two men; in the female group one patient was taking an oral contraceptive, one was in the postpart um period, and the third was a smoker. Only the three women received i ntravenous alteplase and their ejection fraction was normal; both men had impaired left ventricular function. Two patients had SCAD of the l eft anterior descending coronary artery and three of the right coronar y artery. Only the two men had angiographic features of coronary ather osclerotic involvement. No patients required surgical revascularisatio n or percutaneous transluminal coronary angioplasty. At a mean follow up of 27 months (range 6 to 40) all patients were alive and all but on e were asymptomatic.