This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hayes, C. R. Articles by Lewis, D. Search for Related Content PubMed PubMed Citation Articles by Hayes, C. R. Articles by Lewis, D. Pubmed/NCBI databases Medline Plus Health Information Atrial Fibrillation Social Bookmarking                         What's this?

Spontaneous Coronary Artery Dissection of the Left Circumflex Artery Causing Cardiac Tamponade and Presenting With Atrial Fibrillation: A Case Report and Review of the Literature

Hereford Hospital NHSTrust, Herefordshire, chrisruhayes{at}doctors.org.uk

Debbie Lewis, MRCP

Darent Valley Hospital NHS Trust, Dartford, Kent, United Kingdom

Spontaneous coronary artery dissection is rare. When it does occur, it can present in a myriad of ways and can mimic more common clinical scenarios. Undiagnosed it can be fatal. In this article, the authors present a case of coronary artery dissection in a middle aged man presenting as fast atrial fibrillation with hemodynamic compromise. He was unsuccessfully cardioverted and later arrested and died. Postmortem showed a ruptured dissection of the left circumflex artery causing cardiac tamponade and death. Incidence, associations, pathophysiology, investigations, and treatment options are reviewed.

References

• Pretty HC: Dissecting aneurysm of a coronary artery in a woman age 42. BMJ 1:667, 1931.[Free Full Text]
• Thompson EA, Ferrais SE, Gress T., et al: Gender differences and predictors of mortality in spontaneous coronary artery dissection: A review of reported cases. J Invasive Cardiol 17:59-61, 2005.[Medline] [Order article via Infotrieve]
• Kamineni R., Sadhu A., Alpert JS: Spontaneous coronary artery dissection: Report of two cases and a 50 year review of the literature. Cardiol Rev 10:279-284, 2002.[CrossRef][Medline] [Order article via Infotrieve]
• De Maio SJ, Kinsella SH, Silverman ME: Clinical course and long term prognosis of spontaneous coronary artery dissection. Am J Cardiol 64:471-474, 1989.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Koul AK, Hollander G., Moskovits N., et al: Coronary artery dissection during pregnancy and the postpartum period: Two case reports and review of literature. Catheter Cardiovasc Interv 52:88-94, 2001.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Judkins DA, Miller SJ, Capone RJ, Houghton JL: Spontaneous multi-vessel coronary dissection: Repeated presentation in a healthy postmenopausal women. Clin Cardiol 22:677-680, 1999.[Web of Science][Medline] [Order article via Infotrieve]
• Azman MN, Roberts DH, Logan WF: Spontaneous coronary artery dissection in association with oral contraceptive use. Int J Cardiol 48:195-198, 1995.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Celik SK, Sagcan A., Altintig A., et al: Primary spontaneous coronary artery dissections in atherosclerotic patients. Report of nine cases with review of pertinent literature. Eur J Cardiothorac Surg 20:573-576, 2001.[Abstract/Free Full Text]
• Fournier JA, Lopez-Pardo F., Fernandez-Cortaceru JA, et al: Spontaneous coronary dissection in mitral stenosis. Eur Heart J 16:569-571, 1995.
• Greenblatt JM, Kochar GS, Albornoz MA: Multivessel spontaneous coronary artery dissection in a patient with severe systolic hypertension: A possible association. A case report. Angiology 50:509-513, 1999.[Web of Science][Medline] [Order article via Infotrieve]
• Imamura M.: Acute myocardial infarction in a patient with coronary dissection and severe coronary vasospasm. A case report. Angiology 46:951-955, 1995.[Web of Science][Medline] [Order article via Infotrieve]
• Lie JT, Rerg KK: Isolated fibromuscular dysplasia of the coronary arteries with spontaneous dissection and myocardial infarction. Hum Pathol 18:654-656, 1987.[Web of Science][Medline] [Order article via Infotrieve]
• Krishnamurthy M., Desai R., Patel H.: Spontaneous coronary dissection in the postpartum period: Association with antiphospholipid antibody. Heart 90:53, 2004.[CrossRef]
• Sharma AK, Farb A., Manier P., et al: Spontaneous coronary artery dissection in a patient with systemic lupus erythematosis. Hawaii Med J 62:248-253, 2003.[Medline] [Order article via Infotrieve]
• Lepper PM, Wolfgang K., Moller P., et al: A case of sudden cardiac death due to isolated eosinophilic coronary arteritis. Chest 128:1047-1050, 2005.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Catanese V., Venot P., Lemesle F., et al: Myocardial infarction by spontaneous dissection of the coronary arteries in a subject with type IV Ehlers-Danlos syndrome. Presse Med 24:1324-1347, 1995.[Web of Science]
• Najaf SM, Quraishi AU, Kazmi KA: Spontaneous multivessel coronary artery dissection associated with elevated homocysteine levels. J Coll Physicians Surg Pak 15:108-109, 2005.[Medline] [Order article via Infotrieve]
• Ehya H., Weitzner S.: Postpartum dissecting aneurysm of coronary arteries in a patient with sarcoidosis. South Med J 73:57-88, 1980.
• Srinivas M., Basumani P., Muthusamy R., et al: Active inflammatory bowel disease and coronary artery dissection. Postgrad Med J 81:68-70, 2005.[Abstract/Free Full Text]
• Ellis CJ, Haywood GA, Monro JL: Spontaneous coronary artery dissection in a young woman resulting from an intense gymnasium workout. Int J Cardiol 48:195-198, 1995.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Velusamy M., Fisherkeller M., Keenan ME, et al: Spontaneous coronary dissection in a young woman precipitated by retching. J Invasive Cardiol 14:198-201, 2002.[Medline] [Order article via Infotrieve]
• Schifferdecker B., Pacifico L., Ramsaran EK, et al: Spontaneous coronary dissection associated with sexual intercourse. Am J Cardiol 55:1323-1324, 2004.
• Bizzarri F., Mondillo S., Guerrini F., et al: Spontaneous acute coronary dissection after cocaine abuse in a young woman. Can J Cardiol 19:297-299, 2003.[Web of Science][Medline] [Order article via Infotrieve]
• Abbott JD, Curtis JP, Murad K., et al: Spontaneous coronary dissection in a woman receiving 5-fluorouracil- a case report. Angiology 54:721-724, 2003.[Web of Science][Medline] [Order article via Infotrieve]
• Asuncion CM, Hyun J.: Dissecting intramural haematoma of the coronary artery in pregnancy and the puerperium. Obstet Gynaecol 40:202-210, 1972.[Web of Science][Medline] [Order article via Infotrieve]
• Barger AC, Beeuwkes R. III, Laincy LL, et al: Hypothesis: Vasa vasorum and neovascularization of human coronary arteries. A possible role in the pathophysiology of atherosclerosis. N Engl J Med 310:175-177, 1984.[Web of Science][Medline] [Order article via Infotrieve]
• Robinowitz M., Virmani R., McAllister HA Jr: Spontaneous coronary artery dissection and eosinophilic inflammation: A cause and effect relationship? Am J Pathol 72:923-928, 1982.
• Dowling GP, Buja LM: Spontaneous coronary artery dissection with and without periadventitial inflammation. Arch Pathol Lab Med 111:470-472, 1987.[Web of Science][Medline] [Order article via Infotrieve]
• Conraads VM, Vorlat A., Colpaert CG, et al: Spontaneous dissection of three major coronary arteries subsequent to cystic medial necrosis. Chest 116:1473-1475, 1999.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Siegel RJ, Koponen M.: Spontaneous coronary artery dissection causing sudden death. Mechanical arterial failure or primary vasculitis? Arch Pathol Lab Med 118:196-198, 1994.[Web of Science][Medline] [Order article via Infotrieve]
• Nishikawa H., Nakanishi S., Nishiyama S., et al: Primary coronary artery dissection observed at coronary angiography. Am J Cardiol 61:645-648, 1998.
• Kay IP, Wilkins GT, Williams JA: Spontaneous acute coronary dissection presenting as unstable angina. J Invasive Cardiol 10:274-276, 1998.[Medline] [Order article via Infotrieve]
• Basso C., Morgagni GL, Thiene G.: Spontaneous coronary artery dissection. A neglected cause of acute myocardial ischaemia and sudden death. Heart 75:451-454, 1996.[Abstract/Free Full Text]
• Badmanaban B., McCarthy D., Mole D., et al: Spontaneous coronary artery dissection presenting as cardiac tamponade. Ann Thorac Surg 73:1324-1326, 2002.[Abstract/Free Full Text]
• Bergen E., Huffer L., Peele M.: Survival after spontaneous coronary artery dissection presenting with ventricular fibrillation arrest. J Invasive Cardiol 17:E4-E6, 2005.[Medline] [Order article via Infotrieve]
• Daniotti A., Povolo G., Barchitta A., et al: Spontaneous coronary artery dissection mimicking aortic dissection. Cardiovasc Pathol 13:330-333, 2005.[CrossRef][Web of Science]
• Porto I., Banning AB: Intravascular ultrasound imaging in the diagnosis and treatment of spontaneous coronary dissection with drug-eluting stents. J Invasive Cardiol 16:8-80, 2004.
• Maehara A., Mintz GS, Castagna MT, et al: Intravascular ultrasound assessment of Spontaneous coronary artery dissection. Am J Cardiol 89:466-468, 2002.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Yavuzgil O., Akilli A., Islamoglu F.: Clinical images: Spontaneous dissection and intramural haematoma of the coronary arteries without an angiographic intimal flap. J Invasive Cardiol 17:556-558, 2005.[Medline] [Order article via Infotrieve]
• Kearney P., Erbel R., Ge J., et al: Assessment of spontaneous coronary artery dissection by intravascular ultrasound in a patient with unstable angina. Cathet Cardiovasc Diagn 32:58-61, 1994.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Lerakis S., Manoukian S., Martin RP: Transesophageal echo detection of postpartum coronary artery dissection. J Am Soc Echocardiogr 14:1132-1133, 2001.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Manghat NE, Morgan-Hughes GJ, Roobottom CA, et al: Spontaneous coronary artery dissection appearance and follow up on multi-detector row CT coronary angiography. Clin Radiol 60:1120-1125, 2005.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Sarmento-Leite R., Marchado PR, Garcia SL: Spontaneous coronary artery dissection: Stent it or wait for healing. Heart 89:164, 2003.[Free Full Text]
• Cheung S., Mithani V., Watson RM: Healing of spontaneous coronary dissection in the context of glycoprotein IIB/IIIA inhibitor therapy: A case report. Catheter Cardiovasc Interv 51:95-100, 2000.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Koller PT, Cliffe CM, Ridley DJ: Immunosuppressive therapy for peripartum-type spontaneous coronary artery dissection: A case report. Clin Cardiol 21:40-46, 1998.[Web of Science][Medline] [Order article via Infotrieve]
• Ramamerti S., Mahrer PR, Magnusson P., et al: Idiopathic coronary artery dissection: A rare in vivo diagnosis. Clin Cardiol 8:57-60, 1985.[Web of Science][Medline] [Order article via Infotrieve]
• Benham R., Tillinghast S.: Thrombolytic therapy in spontaneous coronary artery dissection. Clin Cardiol 14:611-614, 1991.[Web of Science][Medline] [Order article via Infotrieve]
• Buys EM, Suttorp MJ, Morshuis WJ, et al: Extension of spontaneous coronary dissection due to thrombolytic therapy. Cathet Cardiovasc Diagn 33:157-160, 1994.[Web of Science][Medline] [Order article via Infotrieve]
• Zupan I., Noc M., Trinkaus D., et al: Double vessel extension of spontaneous left main coronary artery dissection due to thrombolytic therapy. Catheter Cardiovasc Interv 52:226-230, 2001.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Fish RD: Clinico-pathologic conference. A 37 year old women with angina pectoris. Circulation 89:898-908, 1994.[Free Full Text]
• Hong MK, Satler LF, Mintz GS, et al: Treatment of spontaneous coronary artery dissection with intracoronary stenting. Am Heart J 132:200-202, 1996.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Carrascosa PM, Ares MA, Gill JZ: Intracoronary stenting for postpartum coronary artery dissection. Ann Intern Med 128:873, 1998.[Free Full Text]
• Gonzales JI, Hill JA, Conti CR: Spontaneous coronary artery dissection treated with percutaneous transluminal angioplasty. Am J Cardiol 63:885-886, 1989.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Tongi M., Amann FW, Follath F.: Spontaneous multivessel coronary artery dissection treated successfully with stent implantation. Am J Med 107:407-408, 1999.[Web of Science][Medline] [Order article via Infotrieve]
• Thayer JO, Healy RW, Maggs PR, et al: Spontaneous coronary artery dissection. Ann Thorac Surg 44:97-102, 1987.[Abstract]
• Curiel P., Spinelli G., Petrella A., et al: Postpartum coronary artery dissection followed by heart transplant. Am J Obstet Gynaecol 163:538-539, 1990.[Web of Science][Medline] [Order article via Infotrieve]

This version was published on November 1, 2007

Angiology, Vol. 58, No. 5, 630-635 (2007)
DOI: 10.1177/0003319707304532


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hayes, C. R. Articles by Lewis, D. Search for Related Content PubMed PubMed Citation Articles by Hayes, C. R. Articles by Lewis, D. Pubmed/NCBI databases Medline Plus Health Information Atrial Fibrillation Social Bookmarking                         What's this?