Spontaneous left main coronary artery dissection complicated with vasospasm

Spontaneous left main coronary artery dissection complicated with vasospasm

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CASE PRESENTATION We present the case of a 36-year-old female (informed consent obtained) with a past medical history of childbirth 2 months before being admitted to the emergency room with signs of chest pain with irradiation to her left arm associated with diaphoresis and dyspnea with 1-hour evolution.The electrocardiogram (ECG) performed did not show any alterations, but merrick backcountry wet cat food the blood test confirmed the presence of increased myocardial necrosis markers (troponin I, 1.9 ng/mL; normal < 0.045 ng/mL).The serial ECGs performed revealed progressive alterations, namely T-wave inversion in leads I, aVL, and V1-V3.

The transthoracic echocardiogram showed good systolic left ventricular function without wall motion alterations.The patient underwent a coronary angiography that revealed an image suggestive of intramural hematoma conditioning a diffuse stenosis of the left main (LMCA) and proximal left anterior descending (LAD) coronary arteries (video 1 of the supplementary data; figure 1A).Due to the patient’s high-risk coronary anatomy, quadruple topical ointment for dogs it was decided to repeat the coronary angiography 8 days later.However, after cannulating the LMCA (6-Fr JL 3.5), a sudden reduction of the distal LMCA and proximal LAD flow was seen (probable vasospasm) (video 2 of the supplementary data; figure 1B).

Consequently, the guidewire was crossed to the.