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I quickly reviewed the patient’s records and saw that she was a 53 year old woman with a history of BMI 40, but no other identifiable riskfactors for coronary artery disease. The final diagnosis was spontaneous coronary artery dissection (SCAD) starting in the mid LAD and continuing distally where it wraps around the apex.
Marked differences can be seen in the prevalence of coronary artery stenosis at autopsy by age and gender. In 30-39 year old women the rate of coronary stenosis at autopsy was 5/1,545 (0.3%) while 60-69 year old men had a prevalence of 12%, almost 40 times higher. The results of this dataset by age and gender follow.
distal stenosis or occluded small branches), and 3) nonischemic causes for myocyte injury (e.g., Spontaneous coronary artery dissection (SCAD) should be considered as a cause of MINOCA. If there is any evidence of atherosclerosis, modifiable CAD riskfactors should be treated aggressively. myocarditis).
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