Dissecção espontânea de artéria coronária: relato de caso

Autores

DOI:

https://doi.org/10.47456/rbps.v25isupl_2.40999

Palavras-chave:

Dissecção espontânea de artéria coronária, Síndrome coronária aguda, Infarto agudo do miocárdio

Resumo

Introdução: A dissecção espontânea de artéria coronária (DEAC) é uma causa rara e não ateroscle­rótica de síndrome coronariana aguda, infarto do miocárdio e morte súbita, atingindo tipicamente mulheres jovens e sem fatores de risco tradicionais para doenças cardiovasculares. Os fatores de risco diferem da doença aterosclerótica, estando associada com sexo feminino, gravidez e estresse físico e emocional e arteriopatias sistêmicas concomitantes, particularmente displasia fibromuscular. Obje­tivos: Mostrar etiologia rara de infarto agudo do miocárdio, causado por dissecção espontânea de artéria coronária em paciente sem fatores de risco para doença coronariana. Além disso, ressaltar a importância do diagnóstico diferencial e precoce, bem como discutir o tratamento e desfechos asso­ciados. Métodos: estudo observacional descritivo cujos dados foram obtidos dos prontuários médi­cos. A pesquisa foi realizada no Hospital Universitário Cassiano Antônio Moras. Resultados: Rela­ta-se o caso de paciente jovem e sem fatores de risco, internada por DEAC de Artéria Descendente Anterior. Paciente recebeu tratamento conservador e encontra-se assintomática e sem recorrência da doença segmento após 32 meses do evento primário. Conclusão: A DEAC é uma entidade clínica subdiagnosticada tanto pelo baixo índice de suspeita quanto da falta de familiaridade com suas as variantes angiográficas. O diagnóstico precoce e adequado é essencial devido ao potencial de morte súbita cardíaca e aumento do risco de eventos cardíacos futuros, incluindo dissecção recorrente.

Downloads

Não há dados estatísticos.

Referências

Hayes SN, Kim ESH, Saw J, Adlam D, Arslanian-Engoren C, Economy KE, Ganesh SK, Gulati R, Lindsay ME, Mieres JH, Naderi S, Shah S, Thaler DE, Tweet MS, Wood MJ; American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Med¬icine; and Stroke Council. Spontaneous Coronary Artery Dis¬section: Current State of the Science: A Scientific Statement from the American Heart Association. Circulation. 2018 May 8;137(19):e523-e557. doi: 10.1161/CIR.0000000000000564. Epub 2018 Feb 22. PMID: 29472380; PMCID: PMC5957087.

Adlam D, Alfonso F, Maas A, Vrints C; Writing Committee. European Society of Cardiology, acute cardiovascular care asso¬ciation, SCAD study group: a position paper on spontaneous coronary artery dissection. Eur Heart J. 2018 Sep 21;39(36):3353- 3368. doi: 10.1093/eurheartj/ehy080. PMID: 29481627; PMCID: PMC6148526.

Manhaes E de B, Gomes WF, Bezerra CG, Horta PE, Gama MN da, Cesar LAM, et al.. Dissecção Espontânea de Artéria Coronária: Abordagem Terapêutica e Desfechos de Uma Série Consecutiva de Casos. Rev Bras Cardiol Invasiva [Internet]. 2014Jan;22 (Rev. Bras. Cardiol. Invasiva, 2014 22(1)):32–5. Avail¬able from: https://doi.org/10.1590/0104-1843000000007)

Saw J, Humphries K, Aymong E, Sedlak T, Prakash R, Staro¬voytov A, et al. Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence. J Am Coll Cardiol. 2017;70(9):1148-58. doi: 10.1016/j.jacc.2017.06.055

Hayes SN, Tweet MS, Adlam D, Kim ESH, Gulati R, Price JE, Rose CH. Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Aug 25;76(8):961-984. doi: 10.1016/j.jacc.2020.05.084. PMID: 32819471.

Boulmpou A, Kassimis G, Zioutas D, Meletidou M, Mouselimis D, Tsarouchas A, Tzikas S, Vassilikos V, Kanonidis I, Tsounos I, Papadopoulos CE. Spontaneous Coronary Artery Dissection (SCAD): Case Series and Mini Review. Cardiovasc Revasc Med. 2020 Nov;21(11):1450-1456. doi: 10.1016/j.carrev.2020.03.013. Epub 2020 Mar 9. PMID: 32173331.

C. Lettieri , D. Zavalloni , R. Rossini , et al. Management and Long-Term Prognosis of Spontaneous Coronary Artery Dissec¬tion, The American Journal of Cardiology, Volume 116, Issue 1, 2015, Pages 66-73, ISSN 0002-9149, https://doi.org/10.1016/j. amjcard.2015.03.039. (https://www.sciencedirect.com/science/ article/pii/S0002914915010450)

Kaadan MI, MacDonald C, Ponzini F, Duran J, Newell K, Pitler L, Lin A, Weinberg I, Wood MJ, Lindsay ME. Prospective Cardio¬vascular Genetics Evaluation in Spontaneous Coronary Artery Dissection. Circ Genom Precis Med. 2018 Apr;11(4):e001933. doi: 10.1161/CIRCGENETICS.117.001933. PMID: 29650765.

Kwon TG, Gulati R, Matsuzawa Y, Aoki T, Guddeti RR, Herr¬mann J, Lennon RJ, Ritman EL, Lerman LO, Lerman A. Prolif¬eration of Coronary Adventitial Vasa Vasorum in Patients With Spontaneous Coronary Artery Dissection. JACC Cardiovasc Imaging. 2016 Jul;9(7):891-892. doi: 10.1016/j.jcmg.2015.11.030. PMID: 27388667.

Saw J, Mancini GBJ, Humphries KH. Contemporary Review on Spontaneous Coronary Artery Dissection. J Am Coll Car¬diol. 2016 Jul 19;68(3):297-312. doi: 10.1016/j.jacc.2016.05.034. Erratum in: J Am Coll Cardiol. 2016 Oct 4;68(14):1606. PMID: 27417009.

Lionakis N, Briasoulis A, Zouganeli V, Dimopoulos S, Kalpakos D, Kourek C. Spontaneous coronary artery dissection: A review of diagnostic methods and management strategies. World J Car¬diol. 2022 Oct 26;14(10):522-536. doi: 10.4330/wjc.v14.i10.522. PMID: 36339886; PMCID: PMC9627356.

Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ, et al. Clinical features, management, and prognosis of sponta¬neous coronary artery dissection. Circulation. 2012;126(5):579- 588. doi: 10.1161/CIRCULATIONAHA.112.105718.

Nakashima T, Noguchi T, Haruta S, Yamamoto Y, Oshima S, Nakao K, Taniguchi Y, Yamaguchi J, Tsuchihashi K, Seki A, Kawasaki T, Uchida T, Omura N, Kikuchi M, Kimura K, Ogawa H, Miyazaki S , Yasuda S. Prognostic impact of spontaneous coronary artery dissection in young female patients with acute myocardial infarction: A report from the Angina Pectoris– Myocardial Infarction Multicenter Investigators in Japan . Int J Cardiol . 2016 ; 207 :341–348. doi: 10.1016/j.ijcard.2016.01.188. Crossref Medline Google Scholar

Mahmoud AN, Taduru SS, Mentias A, Mahtta D, Barakat AF, Saad M, Elgendy AY, Mojadidi MK, Omer M, Abuzaid A, Agarwal N, Elgendy IY, Anderson RD, Saw J. Trends of Inci¬dence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis. JACC Cardiovasc Interv. 2018 Jan 8;11(1):80-90. doi: 10.1016/j.jcin.2017.08.016. Epub 2017 Dec 13. PMID: 29248409.

Alfonso F, Paulo M, Gonzalo N, Dutary J, Jimenez-Quevedo P, Lennie V, Escaned J, Bañuelos C, Hernandez R, Macaya C. Diag¬nosis of spontaneous coronary artery dissection by optical coher¬ence tomography. J Am Coll Cardiol. 2012 Mar 20;59(12):1073-9. doi: 10.1016/j.jacc.2011.08.082. PMID: 22421300.

Yip A, Saw J. Spontaneous coronary artery dissection-A review. Cardiovasc Diagn Ther. 2015 Feb;5(1):37-48. doi: 10.3978/j. issn.2223-3652.2015.01.08. PMID: 25774346; PMCID: PMC4329168.

Alfonso F, Paulo M, Lennie V, Dutary J, Bernardo E, Jiménez-Que¬vedo P, Gonzalo N, Escaned J, Bañuelos C, Pérez-Vizcayno MJ, Hernández R, Macaya C. Spontaneous coronary artery dis¬section: long-term follow-up of a large series of patients pro¬spectively managed with a “conservative” therapeutic strategy. JACC Cardiovasc Interv. 2012 Oct;5(10):1062-70. doi: 10.1016/j. jcin.2012.06.014. PMID: 23078737.

Andreou AY, Georgiou PA, Georgiou GM. Spontaneous cor¬onary artery dissection: Report of two unsuspected cases ini¬tially treated with thrombolysis. Exp Clin Cardiol. 2009 Win¬ter;14(4):e89-92. PMID: 20198198; PMCID: PMC2827215.

Goh AC, Lundstrom RJ. Spontaneous Coronary Artery Dis¬section with Cardiac Tamponade. Tex Heart Inst J. 2015 Oct 1;42(5):479-82. doi: 10.14503/THIJ-14-4260. PMID: 26504447; PMCID: PMC4591893.

Tweet MS, Eleid MF, Best PJ, Lennon RJ, Lerman A, Rihal CS, Holmes DR Jr, Hayes SN, Gulati R. Spontaneous coronary artery dissection: revascularization versus conservative ther¬apy. Circ Cardiovasc Interv. 2014 Dec;7(6):777-86. doi: 10.1161/ CIRCINTERVENTIONS.114.001659. Epub 2014 Nov 18. PMID: 25406203.

Amsterdam EA, Wenger NK, Brindis RG, Casey DE Jr, Gani¬ats TG, Holmes DR Jr, Jaffe AS, Jneid H, Kelly RF, Kontos MC, Levine GN, Liebson PR, Mukherjee D, Peterson ED, Sabatine MS, Smalling RW, Zieman SJ. 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coro¬nary Syndromes: a report of the American College of Cardiol¬ogy/American Heart Association Task Force on Practice Guide¬lines. J Am Coll Cardiol. 2014 Dec 23;64(24):e139-e228. doi: 10.1016/j.jacc.2014.09.017. Epub 2014 Sep 23. Erratum in: J Am Coll Cardiol. 2014 Dec 23;64(24):2713-4. Dosage error in article text. PMID: 25260718.

Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC Jr, Watson K, Wilson PW, Eddleman KM, Jarrett NM, LaBresh K, Nevo L, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brin¬dis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr, Tomaselli GF; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S1-45. doi: 10.1161/01.cir.0000437738.63853.7a. Epub 2013 Nov 12. Erra¬tum in: Circulation. 2014 Jun 24;129(25 Suppl 2):S46-8. Erratum in: Circulation. 2015 Dec 22;132(25):e396. PMID: 24222016.

Downloads

Publicado

24.09.2023

Como Citar

1.
Altoé Falqueto E, Torres Gomes FL. Dissecção espontânea de artéria coronária: relato de caso. RBPS [Internet]. 24º de setembro de 2023 [citado 7º de outubro de 2024];25(supl_2):53-60. Disponível em: https://periodicos.ufes.br/rbps/article/view/40999

Edição

Seção

Relato de Caso