Article ; Online: Atherosclerotic spontaneous coronary artery dissection (A-SCAD) in a patient with COVID-19: case report and possible mechanisms.
European heart journal. Case reports
2020 Volume 4, Issue FI1, Page(s) 1–6
Abstract: ... Case summary: In this report we describe a case of a COVID-19 patient with past cardiac history of CAD ... Background: Spontaneous coronary artery dissection (SCAD) may be atherosclerotic (A-SCAD) or non ... COVID-19 could induce a vascular inflammation localized in the coronary adventitia and periadventitial ...
| Abstract | Background: Spontaneous coronary artery dissection (SCAD) may be atherosclerotic (A-SCAD) or non-atherosclerotic (NA-SCAD) in origin. Contemporary usage of the term 'SCAD' is typically synonymous with NA-SCAD. COVID-19 could induce a vascular inflammation localized in the coronary adventitia and periadventitial fat and contribute to the development of an A-SCAD of a vulnerable plaque in a susceptible patient. Case summary: In this report we describe a case of a COVID-19 patient with past cardiac history of CAD who was admitted for acute coronary syndrome (ACS). Coronary angiography demonstrated the culprit lesion in the proximal LAD that presented with a very complex and unusual morphology, indicative of an A-SCAD. The diagnosis of A-SCAD was supported by the presence of a mild stenosis in the same coronary segment in the last angiogram performed 3 years previously. He was successfully treated by PCI, had a favourable course of the COVID-19 with no symptoms of pneumonia, and was discharged from the hospital after two negative tests for SARS-CoV-2. Discussion: A higher index of suspicion of A-SCAD is needed in patients with suspected or confirmed COVID-19 presenting with ACS. The proposed approach with 'thrombolysis first' for treating STEMI patients with suspected or confirmed COVID-19 infection could be unsafe in the case of underlying A-SCAD. |
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| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-05-12 |
| Publishing country | England |
| Document type | Case Reports |
| ISSN | 2514-2119 |
| ISSN (online) | 2514-2119 |
| DOI | 10.1093/ehjcr/ytaa133 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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