Multiple Spontaneous Coronary Artery Dissections: An Uncommon Cause of Acute Coronary Syndrome in a Syrian Refugee
Spontaneous coronary artery dissection is an uncommon nonatherosclerotic cause of acute coronary syndrome. It usually occurs in young women and is often associated with fibromuscular dysplasia, connective tissue diseases, and pregnancy or postpartum states. We present a case of a Syrian woman with a history of grand multiparity and recent miscarriage who presented with non-ST-elevation myocardial infarction and was found to have multivessel spontaneous coronary artery dissection and severe left ventricular dysfunction.
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Figure 1. (A) Left anterior oblique (LAO) caudal projection showing contrast staining of arterial wall at mideleft anterior descending artery
(white arrow) and spiral dissection involving ostium of the ramus intermedius and left circumflex (black arrow). (B) LAO cranial projection showing contrast wall staining and radiolucent lumen at mideleft anterior descending artery (arrow), likely representing thrombus. (C) LAO cranial projection of right coronary artery showing no disease or atherosclerosis.