Abstract
Spontaneous coronary artery dissection (SCAD) is characterized by
intramural hematoma in a coronary artery leading to partial or complete
vessel obstruction. A 51-year-old female was hospitalized with acute
myocardial infarction and cardiogenic shock. She was diagnosed with
severe SCAD, affecting the proximal left coronary artery. A complex
percutaneous coronary intervention, complicated by cardiac arrest and
need for cardio pulmonary support, succeeded with stent insertion and
revascularization. In the following days the patient developed severe
heart failure due to extensive cardiac reperfusion injury, and
subsequently experienced multiple organ failure, ultimately resulting in
death. The patient had previously been acutely hospitalized twice with
myocardial infarctions and was both times also diagnosed with SCAD
affecting the left coronary artery. This case highlights an unfortunate
patient outcome due to recurrent SCAD, and serves as an important
reminder to consider SCAD differential diagnostically in younger female
patients with myocardial infarction.