CORONARY-ARTERY STENTING FOR SPONTANEOUS CORONARY-ARTERY DISSECTION -A CASE-REPORT AND REVIEW OF THE LITERATURE

Spontaneous coronary artery dissection is an uncommon cause of acute c oronary syndromes. It occurs in three major groups: in young women in the peripartum period, in patients with atherosclerotic disease, and i n an idiopathic group. There are a number of associated conditions, bu t the pathogenesis remains unclear. Diagnosis can only be made at angi ography. Treatments include medical therapy, coronary artery bypass gr afts, and newer interventional procedures. We report on a case of spon taneous coronary artery dissection involving the left circumflex arter y in a young adult male presenting with a myocardial infarction after exercise. There were no risk factors for coronary artery disease and n o evidence of atherosclerosis on angiography. The dissection was treat ed with primary coronary artery stenting without predilation, achievin g an excellent result. To our knowledge, this is the third known case of successful coronary artery stenting for this condition and the firs t case of primary stenting without prior angioplasty. Cathet. Cardiova sc. Diagn. 45:280-286, 1998. (C) 1998 Wiley-Liss, Inc.