Case Report
 
Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report
Paul Ellis1, Victoria Grey1, Anthony D'Sa2, Derek Connolly3
1Foundation Doctor, Department of Cardiology, Sandwell and West Birmingham NHS Foundation Trust, West Bromwich, West Midlands, United Kingdom.
2Consultant Radiologist, Department of Radiology, Sandwell and West Birmingham NHS Foundation Trust, West Bromwich, West Midlands, United Kingdom.
3Consultant Cardiologist, Centre for Cardiovascular Sciences, University of Birmingham, Birmingham, West Midlands, United Kingdom.

doi:10.5348/ijcri-201602-CR-10589

Address correspondence to:
Dr Paul Ellis
43 Edenbridge Road, Hall Green
Birmingham,West Midlands
United Kingdom

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How to cite this article
Ellis P, Grey V, D'Sa A, Connolly D. Exercise-induced coronary artery dissection in a 54-year-old male without atherosclerosis: A case report. Int J Case Rep Images 2016;7(1):11–14.


Abstract
Introduction: Spontaneous coronary artery dissection (SCAD) is an unusual cause of chest pain most often presenting in peripartum or postpartum women. The SCAD precipitated by exercise in patients without underlying atherosclerosis is very rare and has been described in literature only on a few occasions. It has never been described in a male above the age of 40.
Case Report: We present the case of a 54-year-old male presented with acute ST elevation myocardial infarction having suffered a left anterior descending artery dissection following an intense gym workout. He was successfully managed with coronary stenting. The patient suffered from on-going chest pain after initial recovery and was investigated with CT coronary angiography to assess stent patency and for evidence of underlying coronary artery disease. This showed a calcium score of 0 and no evidence of underlying atherosclerosis with a patent stent.
Conclusion: In conclusion, SCAD should be considered in the differential diagnosis of patients presenting with acute coronary syndrome, even those without coronary risk factors.

Keywords: Atherosclerosis, Coronary artery dissection, Exercise, Spontaneous coronary artery dissection (SCAD)


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Author Contributions
Paul Ellis – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Victoria Grey – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Anthony D'Sa – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Derek Connolly – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Paul Ellis et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.