Spontaneous coronary artery dissection in a woman undergoing pseudomenopause therapy with leuprorelin: A case report

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. SCAD frequently affects women, and may be associated with pregnancy and the peripartum period. Therefore, female sex hormones are thought to play a pathogenetic role. Although pseudomenopause therapy may alter female sex hormone levels similar to those during pregnancy, there are no reported cases of SCAD associated with pseudomenopause therapy. We report the case of a 48-year-old woman who developed SCAD while undergoing pseudomenopause therapy with leuprorelin. This case suggests an association between SCAD and pseudomenopause therapy with leuprorelin. <Learning objective: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). SCAD frequently affects women and is thought to be associated with female sex hormones. Here, we report a case of SCAD in a patient who was undergoing pseudomenopause therapy with leuprorelin to treat uterine fibroids. Young or middle-aged women who present with symptoms suggestive of ACS should be asked about not only pregnancy and menstrual history, but also therapies altering female sex hormones.>