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Six-Vessel Spontaneous Coronary Artery Dissection and Vertebral Artery Dissection in Fibromuscular Dysplasia

Amornpol Anuwatworn1,, Kashif Abbas Shaikh2, Maheedhar Gedela2, Amol Raizada1, Marian Petrasko1

1Department of Cardiology, Sanford Heart Hospital, University of South Dakota Sanford school of Medicine, Sioux Falls, SD, USA

2Department of Internal Medicine, University of South Dakota Sanford school of Medicine, Sioux Falls, SD, USA

American Journal of Medical Case Reports. 2016, 4(2), 55-57. DOI: 10.12691/ajmcr-4-2-6
Published online: August 25, 2017

Abstract

Fibromuscular dysplasia is a non-inflammatory and non-atherosclerotic arteriopathy commonly affecting medium-size renal, carotid, and vertebral arteries. Involvement of the coronary artery is very rare but may cause life-threatening spontaneous dissection. Because it is rare, this disease may go unrecognized. A unique angiographic finding of non-coronary arteries can make an early diagnosis, and prompt treatment is paramount. In this paper, we report on a multiple vessel coronary artery dissection in a female patient who presented with acute stroke symptoms secondary to spontaneous dissection of the left vertebral artery. To date, this is the first case report of the spontaneous dissection of six branches of coronary arteries and the vertebral artery due to fibromuscular dysplasia.

Keywords:

spontaneous coronary artery dissection, vertebral artery dissection, fibromuscular dysplasia, coronary angiogram
[1]  Olin JW, Froehlich J, Gu X, Bacharach JM, Eagle K, Gray BH, Jaff MR, Kim ES, Mace P, Matsumoto AH, McBane RD, Kline-Rogers E, White CJ, Gornik HL (2012) The United States Registry for Fibromuscular Dysplasia: results in the first 447 patients. Circulation 125:3182-3190.View Article  PubMed 
 
[2]  Michelis KC, Olin JW, Kadian-Dodov D, d'Escamard V, Kovacic JC (2014) Coronary artery manifestations of fibromuscular dysplasia. J Am Coll of Cardiol 64:1033-1046.View Article  PubMed 
 
[3]  Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ, Gersh BJ, Khambatta S, Best PJ, Rihal CS, Gulati R (2012) Clinical features, management, and prognosis of spontaneous coronary artery dissection. Circulation 126:579-588.View Article  PubMed 
 
[4]  Antoniucci D, Magi Diligenti L (1990) Spontaneous dissection of the three major coronary arteries. Eur Heart 11(12):1130-1134.
 
[5]  Rensing BJ, Kofflard M, van den Brand MJ, Foley DP (1999) Spontaneous dissections of all three coronary arteries in a 33-week pregnant woman. Catheter Cardiovasc Interv 48(2):207-210.View Article 
 
[6]  Maresta A, Varani E, Balducelli M, Vecchi G (2002) Spontaneous coronary dissection of all three coronary arteries: case description with medium-term angiographic follow-up. Ital Heart J 3(12):747- 751. PubMed 
 
[7]  Ooi A, Lavrsen M, Monro J, Langley SM (2004) Successful emergency surgery on triple-vesselspontaneous coronary artery dissection. Eur J Cardiothorac Surg 26(2):447-449.View Article  PubMed 
 
[8]  Harikrishnan S, Ajithkumar VK, Tharakan JM (2007) Spontaneous coronary artery dissection of all major coronary arteries. Can J Cardiol 23(4):313-314.View Article 
 
[9]  Lunebourg A, Letovanec I, Eggenberger P, Lehr HA (2008) Images in cardiovascular medicine. Sudden cardiac death due to triple vessel coronary dissection. Circulation 117(15):2038-2040.View Article  PubMed 
 
[10]  Akgul A, Gursoy M, Bakuy V, Komurcu G, Caglar IM, Gulmaliyev J (2013) Spontaneous triple coronary artery dissection. Ann Thorac Surg 95(4):1443-1445.View Article  PubMed 
 
[11]  Tweet MS, Eleid MF, Best PJ, Lennon RJ, Lerman A, Rihal CS, Holmes DR, Jr., Hayes SN, Gulati R (2014) Spontaneous coronary artery dissection: revascularization versus conservative therapy. Circ Cardiovasc Interv 7(6): 777-786.View Article  PubMed