1. Dizziness and Pre-Syncope: An Unusual Clinical Presentation of a Spontaneous Coronary Artery Dissection as Revealed by Optical Coherence Tomography

    Dizziness and Pre-Syncope: An Unusual Clinical Presentation of a Spontaneous Coronary Artery Dissection as Revealed by Optical Coherence Tomography

    A 52-year-old woman was admitted to our hospital with a 2-day history of nausea and dizziness and a subsequent pre-syncope. Because of a known bipolar disorder, an emergency psychiatric evaluation was performed and an attempted suicide as suggested by relatives was considered unlikely. Subsequently, an increased troponin T level was observed (0.101 µg/l) and coronary angiography was performed. Coronary angiography revealed a highly variable degree of stenosis of the middle right coronary artery (A and B, arrows) that was unresponsive to intracoronary nitrate administration. Notably, when there was a high degree of stenosis cardiac arrhythmias, in particular sinus ...

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