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Spontaneous Coronary Artery Dissection: Case Report and Literature Review
Authors:Cristian D'Ovidio MD  PhD  Sara Sablone MD  Aldo Carnevale MD  PhD
Institution:Section of Legal Medicine, Department of Medicine and Aging Sciences, ‘G. d'Annunzio’ University of Chieti–Pescara, Chieti, Italy
Abstract:Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction and sudden cardiac death. It occurs most commonly in otherwise healthy women during pregnancy or the postpartum period. The true incidence of SCAD is underestimated, as most cases are diagnosed at autopsy. The pathophysiology of SCAD is still not fully understood, and its management can be challenging. This report describes a 35‐year‐old pregnant female who presented with an acute antero‐lateral ST elevation secondary to spontaneous dissection of the left anterior descending artery and the circumflex artery. The diagnosis was established by coronary artery angiography. However, the patient died following cardiac tamponade. The examination of this case represented a starting point for the reviewing of the diagnosis, clinical course, and management of SCAD, and for the placing of this in context with the existing literature. This study highlights the importance of prompt diagnosis and subsequent lifesaving treatment.
Keywords:forensic science  cardiology  pregnancy  maternal death  coronary artery dissection  autopsy
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