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The final diagnosis was spontaneous coronary artery dissection (SCAD) starting in the mid LAD and continuing distally where it wraps around the apex. SCAD wasn't on my differential per se , but in retrospect it should have been. Most patients presenting with SCAD report a preceding emotional or physical stressor. Buller, C.
Troponin elevation is dependent on presence or absence of occlusion (remember many OMI receive a diagnosis of NSTEMI), duration of occlusion (which is dependent on rapidity of therapy or the luck of spontaneous reperfusion), area of myocardium at risk, collateral circulation, and more. What is Spontaneous Coronary Artery Dissection (SCAD)?
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