Multivessel Spontaneous Coronary Artery Dissection: Amberen as a Possible Risk Factor

Spontaneous coronary artery dissection (SCAD) is a rare phenomenon that causes acute, life-threatening myocardial infarction. Most notably occurring in the female population, certain risk factors have been implicated in SCAD including pregnancy, hormone therapy, stimulant drug use, connective tissue disorders and systemic inflammatory disorders. However, the effects of over-the-counter supplements have not been widely studied in SCAD. We have a case of acute multivessel type 2 SCAD involving the obtuse marginal artery and posterior descending artery that may have been secondary to Amberen, an over-the-counter supplement used to relieve symptoms of menopause. This is a rare case of multivessel SCAD possibly caused by an over-the-counter supplement not previously known to trigger this disease process.