Spontaneous Coronary Artery Dissection and Woven Coronary Artery: Three Cases and a Review of the Literature
A 60-year-old female was presented to the cardiology department with stable angina pectoris that she had experienced for one year. She had been diagnosed with portal vein thrombosis due to protein C deficiency, hypertension and hyperlipidemia. She was on perindopril and warfarin. An electrocardiography (ECG) showed Q waves in the inferior leads. Cardiac catheterization showed a spiral dissection of the proximal right coronary artery (RCA), extending downwards to just below the right ventricle branch (), with distal Thrombolysis in Myocardial Infarction (TIMI)-3 antegrade flow. Ventriculography showed hypokinesis of the inferior wall, and the left ventricle ejection fraction (LVEF) was 45%. A 2.75×30 mm drug-eluting stent was successfully placed along the dissection, reducing the RCA to a single lumen (). Follow-up transthoracic echocardiography showed normal wall motions and ejection fraction. The patient was administered on warfarin, clopidogrel, perindopril and beta-blocker on discharge. At 12 weeks follow-up, she was well and without symptoms.