The role of intravascular ultrasound guidance in the treatment of intramural hematoma probably caused by spontaneous coronary artery dissection in a young woman with acute anterior myocardial infarction

Abstract

Spontaneous coronary artery dissection (SCAD) is known to be a rare but fatal cause of acute coronary syndromes. It is more frequent in young women, particularly in the peripartum period. Intravascular ultrasound (IVUS) has an important role in the diagnosis and management of SCAD. Intramural hematoma that occurs between adventitial and media layer of the vessel wall may occlude the true lumen. IVUS can identify intimal tears, the extension of intramural hematoma and show the adequate compression of intramural hematoma after percutaneous coronary intervention. We present a case of intramural hematoma caused by SCAD in a young woman presenting with acute anterior myocardial infarction, and the role of IVUS in the diagnosis and management of SCAD. (Cardiol J 2012; 19, 5: 532-535)