Conservative management of spontaneous coronary artery dissection: a case report

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes (ACS) that mainly occurs in young women with no risk factors and no coronary atherosclerosis. Diagnosis is made by invasive coronary angiography (CA), computed tomography coronary angiography (CTCA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The rarity of this entity as well as the complications of invasive treatment make it difficult to choose therapy between conservative management, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). We report a case of a 36-year-old woman presented with non ST elevation myocardial infarction (NSTEMI) related to spontaneous dissection of coronary arteries (left main trunk, left anterior descending artery and left circumflex artery) treated medically with spectacular results at 2 months, controlled by CTCA.