Coronary dissection with ST elevation myocardial infarction responding to thrombolytic and conservative therapy alone

Morteza Safi, Ali Reza Serati, Sepideh Emami, Mohammad Reza Movahed

Research output: Contribution to journalArticle

Abstract

In this report, we describe a case of spontaneous coronary dissection involving left anterior descending artery presenting with acute anterior myocardial infarction successfully treated with thrombolytic and conservative therapy with a suggestion that spontaneous resolution of thrombus occurred before coronary intervention could be performed. As we did not have initial angiogram due to patient's refusal, this assumption is speculative. However, this case suggests that dissections may heal spontaneously and could be treated with conservative approach in selected cases based on best clinical judgment. It is important to realize that the clinical course of a major coronary artery dissection remains unpredictable. Therefore, cardiologists should always treat each case individually and consider coronary interventions if conservative treatment is not leading to resolution of ST elevation or in patients with hemodynamic compromise. This case is followed by discussion about conservative versus invasive management of spontaneous coronary dissections.

Original languageEnglish (US)
Pages (from-to)271-274
Number of pages4
JournalFuture Cardiology
Volume16
Issue number4
DOIs
StatePublished - Jul 1 2020
Externally publishedYes

Keywords

  • acute coronary syndrome
  • acute myocardial infarction
  • coronary dissection
  • dissection
  • non-STEMI
  • percutaneous coronary intervention
  • STEMI
  • thrombolytic therapy

ASJC Scopus subject areas

  • Molecular Medicine
  • Cardiology and Cardiovascular Medicine

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