Spontaneous dissection of left main coronary artery extending into anterior descending and first diagonal arteries in young woman with survival: A rare case of myocardial infarction and cardiogenic shock

Abstract

Spontaneous left main coronary artery dissection (SLMD) is quite rare. We report a case of SLMD extending into mid-left anterior descending and mit-first diagonal arteries in a young woman presenting with acute antero-lateral myocardial infarction and cardiogenic shock. Aggressive medical treatment including thrombolytics and intra-aortic balloon pumping (IABP) were all that could be done. She has been well and uneventful for a 5 month follow-up. To our knowledge, our patient with SLMD is the unique cardiogenic shock survivor with medical treatment in the liter¬ature. Thrombolytic therapy and IABP, probably due to augmented coronary perfusion pressure, might be used to maintain late patency of SLMD.