1. Interventional Dilemma in a Young Woman With Spontaneous Coronary Artery Dissection Who Presented With High-Risk Non-ST-Elevation Myocardial Infarction (NSTEMI) Progressing to ST-Elevation Myocardial Infarction (STEMI)

    Interventional Dilemma in a Young Woman With Spontaneous Coronary Artery Dissection Who Presented With High-Risk Non-ST-Elevation Myocardial Infarction (NSTEMI) Progressing to ST-Elevation Myocardial Infarction (STEMI)

    Spontaneous coronary artery dissection (SCAD) is an infrequent presentation of acute myocardial infarction in young women and denotes the non-atherosclerotic separation of the coronary artery wall. Precipitating causes include fibromuscular dysplasia, postpartum hormonal changes, multiparity, connective tissue diseases like Marfan syndrome, autoimmune conditions, and hormonal therapy. It is often underdiagnosed due to a low index of suspicion based on age and gender bias as well as knowledge about different angiographic variants in SCAD. Intracoronary imaging with optical coherence tomography (OCT) or intravascular ultrasound (IVUS) is used for patients where coronary angiography fails to secure a diagnosis to increase the diagnostic ...

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