Spontaneous coronary artery dissection revealed by an iatrogenic spasm provocation test
Edouard Gerbaud, Hubert Cochet, Soumaya SridiAbstract
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of MINOCA. The spontaneous development of an intramural hematoma narrows the true lumen. This narrowing may improve prior to coronary angiography, or may not be appreciated, leading to a diagnosis of MINOCA. We reported the case of a 50-years old woman, active smoker, with a previous history of MINOCA [septo-apical MI on Cardiac Magnetic Resonance (CMR) imaging] who was referred to our institution for recurrent chest pain. Two coronary angiograms, which were previously performed, were considered as normal. We decided to repeat coronary angiography in order to perform a spasm provocation test. Unfortunately, this test during this third examination induced recurrent chest pain and revealed a SCAD.