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BMJ Case Reports 2012; doi:10.1136/bcr-2012-007274
  • Rare disease

Multivessel spontaneous coronary artery dissection treated with staged percutanous coronary intervention in a non-postpartum female

  1. William Bennett1
  1. 1Department of Cardiology, Naval Medical Center San Diego, San Diego, California, USA
  2. 2Department of Internal Medicine, Naval Medical Center San Diego, San Diego, California, USA
  1. Correspondence to Dr Andrew H Lin, alin_1974{at}yahoo.com

Summary

We present a case of a 43-year-old woman who presented with a non-ST elevation myocardial infarction. During her first cardiac catheterisation, she was diagnosed with a chronic total occlusion of the right coronary artery and a flow limiting dissection of her middle left anterior descending artery. The dissection of the left anterior descending artery was stented with two overlapping everolimus-eluting stents. There were no complications from this percutaneous coronary intervention. On the following day, the patient continued to have persistent chest pain and returned to the catheterisation laboratory. It was then found that the patient had a total occlusion of the right coronary artery secondary to dissection. This was also stented with three everolimus-eluting stents with excellent clinical and angiographic results. It is important to consider spontaneous multivessel coronary dissections which can be treated successfully with percutaneous coronary intervention.

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