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Spontana disekcija leve koronarne arterije - prikaz primera = Spontaneous left main coronary artery dissection - a case report
Ambrožič, Jana, kardiologinja ; Kariž, Stojan
Spontaneous coronary artery dissection is a rare entity that can present as acute myocardial infarction or sudden cardiac death. In such cases prompt diagnosis by coronary angiography and urgent ...revascularization is crucial for survival. Thrombolytic therapy may be harmful leading to expansion of an intramural hematoma. The etiology of spontaneous coronary artery dissection isunclear, but different pathogenesis is suspected. We report on a 66-year-oldwoman, admitted to the intensive care unit of a regional hospital with acute myocardial infarction. Initially she was treated with thrombolysis.On the next day acute pulmonary edema developed and the patient was referred for emergency coronary angiography. Dissection of the left main coronary artery was revealed with almost complete occlusion of the left anterior descending and circumflex artery. Aorto-coronary venous by-pass grafting was done successfully with a ligation of the dissection origin at theostium of the left main coronary artery.
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