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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Spontaneous coronary artery dissection in a young man - Case report. | Schmid and Auer Journal of Cardiothoracic Surgery 2011 6 22 http www.cardiothoracicsurgery.Org content 6 1 22 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Spontaneous coronary artery dissection in a young man - Case report Julia Schmid Johann Auer Abstract A 31 year old man with a 17-year-history of drug abuse heroine and cannabis was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending LAD artery with Thrombolysis In Myocardial Infarction TIMI flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD. Background Spontaneous coronary artery dissection SCAD is a rare and uncommon case of sudden cardiac death and acute coronary syndrome 1 . As several diseases and conditions have been associated with SCAD it therefore probably constitutes a heterogeneous entity. Risk factors for SCAD comprise pregnancy Ehlers-Danlos disease Marfan s Syndrome intensive exercise or cocaine abuse 1-4 . The clinical presentation of SCAD depends on the extent and the flow limiting severity of the coronary artery dissection and ranges from asymptomatic to unstable angina acute myocardial infarction ventricular arrhythmias to sudden cardiac death. Coronary angiography is frequently used in the evaluation of patients with acute coronary syndromes. Thus most cases with SCAD are detected by
