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"A patient just arrived as a transfer for NSTEMI."

Dr. Smith's ECG Blog

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.

SCAD 124
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Which patient needs a CT scan?

Dr. Smith's ECG Blog

The blood pressure was 170/100 in the critical care area. Cardiology wanted a CT of the aorta to rule out dissection, presumably partly due to the very high blood pressure readings, but also because it is hard for people to believe that a 20-something woman could have acute thrombotic coronary artery.