Left Main Spontaneous Coronary Artery Dissection: The Complexity of Management Considerations

Abstract

41-year old white female presented to the Emergency Department (ED) with sudden onset, sub-sternal chest pressure, which she characterized as 10/10, radiating to her upper back. She experienced associated nausea and diaphoresis. She was vacuuming the living room at her home when symptoms developed. The patient’s only risk factor was cigarette smoking 1ppd. Her initial ECG showed sinus rhythm with ST-segment elevation in lead aVR, with reciprocal ST-segment depression in the anterior and inferior leads (Figure 1). Abstract