Chronic or Changeable Infarct Size after Spontaneous Coronary Artery Dissection
Gordana Krljanac,
Svetlana Apostolovic,
Zlatko Mehmedbegovic,
Olga Nedeljkovic-Arsenovic,
Ruzica Maksimovic,
Ivan Ilic,
Aleksandra Djokovic,
Lidija Savic,
Ratko Lasica,
Milika Asanin
Affiliations
Gordana Krljanac
University Clinical Center of Serbia, Cariology Clinic, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Svetlana Apostolovic
Clinical Center of Nis, Cardiology Clinic, Faculty of Medicine, University of Nis, 18000 Niš, Serbia
Zlatko Mehmedbegovic
University Clinical Center of Serbia, Cariology Clinic, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Olga Nedeljkovic-Arsenovic
University Clinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Ruzica Maksimovic
University Clinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Ivan Ilic
Institute of Cardiovascular Diseases “Dedinje”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Aleksandra Djokovic
University Hospital Center “Bezanijska Kosa”, Department of Cardiology, Division of Interventional Cardiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Lidija Savic
University Clinical Center of Serbia, Cariology Clinic, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Ratko Lasica
University Clinical Center of Serbia, Cariology Clinic, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Milika Asanin
University Clinical Center of Serbia, Cariology Clinic, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Spontaneous coronary artery dissection (SCAD) could be the cause of acute myocardial infarction (AMI) and sudden cardiac death. Clinical presentations can vary considerably, but the most common is the elevation of cardiac biomarkers associated with chest discomfort. Different pathological etiology in comparison with Type 1 AMI is the underlying infarct size in this population. A 42-year-old previously healthy woman presented with SCAD. Detailed diagnostical processing and treatment which were performed could not prevent myocardial injury. The catheterization laboratory was the initial place for the establishment of a diagnosis and proper management. The management process can be very fast and sometimes additional imaging methods are necessary. Finding predictors of SCAD recurrence is challenging, as well as predictors of the resulting infarct scar size. Patients with recurrent clinical symptoms of chest pain, ST elevation, and complication represent a special group of interest. Therapeutic approaches for SCAD range from the ”watch and wait” method to complete revascularization with the implantation of one or more stents or aortocoronary bypass grafting. The infarct size could be balanced through the correct therapeutical approach, and, proper multimodality imaging would be helpful in the assessment of infarct size.
