06 Nov 2019
Extensive spontaneous coronary artery dissection in STEMI patient undergoing fibrinolysis
#CardioTwitterCase originally published on Twitter
Consult this Twitter Case concerning a 39-year-old female patient with no risk factor for coronary artery disease who presented to the emergency department with anterior STEMI...
This case was originally published on Twitter by @adrianocaixeta via #CardioTwitterCase
Clinical presentation
A 39-year-old female patient with no risk factor for coronary artery disease presented to the emergency department with anterior STEMI. The patient received IV fibrinolysis with full dose of tenecteplase before transfer to a tertiary centre for invasive angiography. Coronary angiography showed an extensive narrowing and intraluminal filling defect extending from the proximal and distal-LAD, suggesting type 1 SCDA.
Case management
Since the patient was stable, she was managed with clinical treatment.
Treating SCAD patient with fibrinolysis may worsen coronary dissection...
Original tweet and Twitter discussion
39 y/o female with no risk factor for CAD. Presented with anterior STEMI and treated with tenecteplase. The angiography shows an extensive SCAD in the LAD. Fibrinolysis may worsen the angiographic apperance in SCAD pts. @SCADalliance@SharonneHayes@docsaw#cardiotwitterpic.twitter.com/mBjPqe0rqc
— Adriano Caixeta MD, PhD (@adrianocaixeta) 11 octobre 2019
1 comment
dear colloge unfortunate when no place for primary pci we give fibronolitic therapy so what they do no mastek but if they do for her angio &with this scad timi iii flow conservative treatment is the best