Spontaneous coronary artery dissection in a young patient: A clinical case
A. A. Bapinaev,
A. A. Bapinaeva,
A. B. Khadzugov,
I. K. Tkhabisimova,
F. Kh. Оrakova,
L. S. Bolotokova,
O. S. Shogenov,
O. A. Miziev,
S. S. Gulaev,
D. A. Nagoeva,
R. M. Abidokov,
I. V. Musov,
D. I. Istepanova,
D. R. Zaifova,
A. A. Urusbambetova https://doi.org/10.21518/ms2025-327
Abstract
Today, cardiovascular diseases continue to be one of the most pressing medical issues worldwide. Spontaneous coronary artery dissection is a fairly rare cause of acute coronary syndrome that is not associated with atherosclerotic plaque. The relevance of studying this condition is associated with high mortality in the acute period: about 50% of patients die suddenly without receiving medical attention. Clinical precursors of repeated spontaneous coronary artery dissection have not been identified. The clinical observation describes the case of 33-year-old patient who was admitted to the Republican Clinical Multidisciplinary Center for High Medical Technologies in Nalchik for diagnostic coronary angiography. Previously, the patient was observed by a vascular surgeon with a diagnosis of obliterating endarteritis of the lower extremities, as well as with echocardiography, a previous myocardial infarction was detected. At the time of the examination, there were no angina attacks or heart failure symptoms. Coronary angiography revealed extensive dissection of various segments of the anterior descending artery, the diagonal branch, the circumflex artery, and the obtuse edge branch. Taking into account the clinical and anamnestic data and the results of angiography, it was decided to refrain from coronary artery angioplasty and coronary artery bypass grafting. Drug therapy with angiotensin-converting enzyme inhibitors, β-blockers and acetylsalicylic acid was prescribed, since revascularization is indicated for high-risk patients.
Keywords
coronary artery disease,
acute coronary syndrome,
coronary angiography,
myocardial revascularization,
post-COVID syndrome
Supporting agencies: The work was supported by the strategic academic leadership program "Priority-2030".
About the Authors
A. A. Bapinaev
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Asker A. Bapinaev, Student
6, Akademik Lebedev St., St Petersburg, 194044
A. A. Bapinaeva
Republican Clinical Multidisciplinary Center for High Medical Technologies;
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Aminat A. Bapinaeva, Cand. Sci. (Med.), Cardiologist, Republican Clinical Multidisciplinary Center for High Medical Technologies; Associate Professor of the Department of General Medical Training and Medical Rehabilitation, Medical Academy, Kabardino-Balkarian State University named after H.M. Berbekov
30а, Shogenov St., Nalchik, Kabardino-Balkarian Republic, 360001;
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
A. B. Khadzugov
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Artur B. Khadzugov, Cand. Sci. (Med.), Chairman of the Russian Society of Cardiologists in the Kabardino-Balkarian Republic, Associate Professor of the Department of General Medical Training and Medical Rehabilitation, Medical Academy, Kabardino-Balkarian State University named after H.M. Berbekov
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
I. K. Tkhabisimova
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Irina K. Tkhabisimova, Cand. Sci. (Med.), Associate Professor, Head of the Department of General Medical Training and Medical Rehabilitation, Medical Academy
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
F. Kh. Оrakova
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Fatima Кh. Оrakova, Cand. Sci. (Med.), Associate Professor of the Department of General Medical Training and Medical Rehabilitation, Medical Academy
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
L. S. Bolotokova
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Lalina S. Bolotokova, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
O. S. Shogenov
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Osman S. Shogenov, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
O. A. Miziev
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Omar A. Miziev, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
S. S. Gulaev
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Sultan S. Gulaev, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
D. A. Nagoeva
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Diana A. Nagoeva, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
R. M. Abidokov
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Reziuan M. Abidokov, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
I. V. Musov
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Islam V. Musov, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
D. I. Istepanova
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Dina I. Istepanova, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
D. R. Zaifova
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation
Russian Federation
Darina R. Zaifova, Student
173, Chernyshevsky St., Nalchik, KabardinoBalkarian Republic, 360004
A. A. Urusbambetova
Kuban State Medical University
Russian Federation
Russian Federation
Alina A. Urusbambetova, Student
4, Mitrofan Sedin St., Krasnodar, 350063
References
1. Чазов ЕИ (ред.). Болезни сердца и сосудов. М.: Медицина; 1992. Т. 1. 496 с.
2. Protasova EA, Furman NV, Titkov IV, Oleynik AO, Gusev KV. Spontaneous dissection of coronary artery as a cause of acute myocardial infarction. Cardiovascular Therapy and Prevention (Russian Federation). 2014;13(5):70–73. (In Russ.) https://doi.org/10.15829/1728-8800-2014-5-70-73.
3. Saw J. Coronary angiogram classification of spontaneous coronary artery dissection. Catheter Cardiovasc Interv. 2014;84(7):1115–1122. https://doi.org/10.1002/ccd.25293.
4. Saw J, Aymong E, Sedlak T, Buller CE, Starovoytov A, Ricci D et al. Spontaneous Coronary Artery Dissection: Association With Predisposing Arteriopathies and Precipitating Stressors and Cardiovascular Outcomes. Circ Cardiovasc Interv. 2014;7(5):645–655. https://doi.org/10.1161/CIRCINTERVENTIONS.114.001760.
5. Zhukova NS, Shakhnovich RM, Merkulova IN, Sukhinina TS, Pevzner DV, Staroverov II. Spontaneous Coronary Artery Dissection. Kardiologiya. 2019;59(9):52–63. (In Russ.) https://doi.org/10.18087/cardio.2019.9.1026911.
6. Bockeria LA, Golukhova EZ, Petrosyan KV, Karaev AV, Grigoryan MR, Losev VV. Spontaneous coronary dissection: case reports and literature review. Creative Cardiology. 2020;14(1):71–81. (In Russ.) https://doi.org/ 10.24022/1997-3187-2020-14-1-71-81.
7. Kuznetsov AA, Namitokov AM, Sazhneva AV, Nekrasov AS Kosmacheva ED. Spontaneous left coronary artery dissection in the postpartum period: a case report. Russian Journal of Cardiology. 2022;27(3S):5059. (In Russ.) https://doi.org/10.15829/1560-4071-2022-5059.
8. Havakuk O, Goland S, Mehra A, Elkayam U. Pregnancy and the Risk of Spontaneous Coronary Artery Dissection: An Analysis of 120 Contemporary Cases. Circ Cardiovasc Interv. 2017;10(3):e004941. https://doi.org/10.1161/CIRCINTERVENTIONS.117.004941.
9. Pregnancy associated spontaneous coronary artery dissection: results of multicenter “virtual” register of spontaneous coronary artery dissection. Evidence-Based Cardiology. 2017;10(3):17–22. (In Russ.) Available at: https://elibrary.ru/zvlawf.
10. Rogers JH, Lasala JM. Coronary artery dissection and perforation complicating percutaneous coronary intervention. J Invasive Cardiol. 2004;16(9): 493–439. Available at: https://pubmed.ncbi.nlm.nih.gov/15353832/.
11. Saw J, Humphries K, Aymong E, Sedlak T, Prakash R, Starovoytov A, Mancini GBJ. Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence. J Am Coll Cardiol. 2017;70(9):1148–1158. https://doi.org/10.1016/j.jacc.2017.06.053.
12. Tweet MS, Olin JW. Insights Into Spontaneous Coronary Artery Dissection: Can Recurrence Be Prevented? J Am Coll Cardiol. 2017;70(9):1159–1161. https://doi.org/10.1016/j.jacc.2017.07.726.
Review
For citations:
Bapinaev AA, Bapinaeva AA, Khadzugov AB, Tkhabisimova IK, Оrakova FK, Bolotokova LS, Shogenov OS, Miziev OA, Gulaev SS, Nagoeva DA, Abidokov RM, Musov IV, Istepanova DI, Zaifova DR, Urusbambetova AA. Spontaneous coronary artery dissection in a young patient: A clinical case. Meditsinskiy sovet = Medical Council. 2025;19(13):35-41. (In Russ.) https://doi.org/10.21518/ms2025-327
Views:
128
Email this article 