| Title: |
P978 Acute myocardial infarction in young women without atherosclerotic disease |
| Authors: |
Sozzi, F B; Schiavone, M; Gherbesi, E; Malanchini, G; Mircoli, L; Colombo, F; Bonanomi, C; Vicenzi, M; Ciulla, M; Lombardi, F |
| Source: |
European Heart Journal - Cardiovascular Imaging ; volume 21, issue Supplement_1 ; ISSN 2047-2404 2047-2412 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2020 |
| Description: |
INTRODUCTION Spontaneous coronary artery dissection (SCAD) is an established cause of acute myocardial infarction (AMI), with an incidence in young women ranging from 22% to 43%. The increased use of coronary angiography contributed to better recognise this condition. Nonetheless, the presentation remains challenging mainly due to the atypical clinical onset. AIMS AND METHODS A very homogeneous case series of 10 young women (age 36 ± 9 years) admitted at our Institution over a period of 10-years with ST-elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI) were analysed. All women had no congenital, coronary, cardiac and/or atherosclerotic disorders. The clinical and angiographic data were evaluated and correlated to the outcome that lasted 5 ± 5 years. RESULTS The clinical presentation was typical in 70% of cases and 30% of them developed ventricular arrhythmias and cardiogenic shock. An atypical presentation was documented in 30%. STEMI accounted for 70%, NSTEMI for 30%. Among the predisposing factors, pregnancy was related in 20%, connective tissue disorders in 30% and acute emotional stress associated to smoke habit in 50% of cases. On coronary angiogram all women were affected by distinctive pattern of non-atherosclerotic single vessel disease: LAD dissection (50% of cases with proximal localization), first obtuse marginal branch dissection in 3 cases, proximal RCA dissection in 1. Medical therapy was the first choice in 40%, while 60% were treated with PTCA-stent (multiple in 30%). The ejection fraction early after AMI was normal in 70%, mildly reduced in 1 case and moderately reduced ( |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ehjci/jez319.608 |
| Availability: |
https://doi.org/10.1093/ehjci/jez319.608; http://academic.oup.com/ehjcimaging/article-pdf/21/Supplement_1/jez319.608/31866178/jez319.608.pdf |
| Rights: |
https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| Accession Number: |
edsbas.2AB38811 |
| Database: |
BASE |