Unexpected cause of NSTEMI in a 50-year-old male: Spontaneous Coronary-Artery Dissection (SCAD)

Spontaneous coronary-artery dissection (SCAD) has emerged as an important cause of myocardial infarction in young people. Although SCAD is uncommon, awareness of both the disease and its angiographic appearance has improved. Accurate and rapid diagnosis is paramount because the management of acute myocardial infarction caused by SCAD differs vastly from that of atherosclerotic myocardial infarction. The use of endocoronary imaging such as IVUS and optical coherence tomography is necessary in case of diagnostic doubt (especially in SCAD type 2 and 3). The optimal management of SCAD remains unclear. A conservative approach should be the preferred strategy. Here we report a case of a 50-year-old male patient who presented with chest pain for 7 days with the diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI). Coronary angiography showed a type 1 SCAD of the obtuse marginal & right coronary artery. The patient was discharged under medical treatment.