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Angiology
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Large Spontaneous Coronary Artery Dissections

A Study of Three Cases, Literature Review, and Possible Therapeutic Strategies

Puneet K. Verma, DM

Departments of Cardiology and Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India, puneet_verma{at}hotmail.com

Manjinder S. Sandhu, DM

Departments of Cardiology and Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Bhagwant R. Mittal, MD

Post Graduate Institute of Medical Education and Research, Chandigarh, India

Naveen Aggarwal, DM

Departments of Cardiology and Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Arvind Kumar, MD

Departments of Cardiology and Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Manas Mayank, DRM

Post Graduate Institute of Medical Education and Research, Chandigarh, India

Anish Bhattacharya, DRM

Post Graduate Institute of Medical Education and Research, Chandigarh, India

Ram K. Anand, BSc

Departments of Cardiology and Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Anil Grover, DM

Departments of Cardiology and Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Spontaneous coronary artery dissection is rare, but is now being increasingly recognized as a prominent cause of acute ischemic coronary events occurring usually in relatively young patients, predominantly females. The authors describe the clinical course of 3 patients (1 woman) in whom large spontaneous coronary artery dissections developed. All had diverse clinical presentations; 1 presenting with heart failure, the second with post-myocardial infarction angina, and the third with syncope. The second patient underwent coronary angioplasty with multiple overlapping stents while in the other two, it was the considered opinion to continue aggressive medical therapy. The 1-year follow-up was uneventful in all 3 patients. The risk factors ascertained in our patients were diabetes mellitus, smoking, and hypertension.

Angiology, Vol. 55, No. 3, 309-318 (2004)
DOI: 10.1177/000331970405500311
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