International Journal of Cardiovascular Sciences. 29/maio/2025;38:e20240013.

Spontaneous Multivessel Coronary Artery Dissection: Case Report

Ana Paula Schonarth , Ottávia Zainho Helbok , Caroline de Oliveira Fischer Bacca , Arieli Carini Michels

DOI: 10.36660/ijcs.20240013

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare condition that can cause acute myocardial infarction (AMI), especially in young women without risk factors for coronary artery disease. Diagnosis is made by cardiac catheterization, and treatment varies from conservative to surgical approaches, depending on the severity. We report the case of a woman with a history of AMI who underwent initial catheterization without requiring percutaneous coronary intervention due to the absence of an obstructive lesion. Subsequently, the patient presented episodes of angina, and a new catheterization was performed, which revealed dissection in the left anterior descending and right coronary arteries. Given the lack of spontaneous resolution of the dissection, which was initially unilateral and progressed to bilateral, the patient underwent myocardial revascularization with mammary artery and saphenous vein bypass grafts. The objective of this study is to document a case of SCAD and to describe its characteristics, diagnosis, and therapeutic management.