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Acta Medica Medianae
Vol. 53, No 1, March, 2014

UDC 61
ISSN 0365-4478(Printed version)
ISSN 1821-2794(Online)


Correspondence to:

Nemanja Stepanović

Neretvljanska 20

Serbia, 18000 Niš

E-mail: nemstep@gmail.com

Case report      


UDC: 616.132.2:616.127-005.8






Svetlana Apostolović1, Miodrag Damjanović1, Dragan Mihailović2, Aleksandra Antović3, Miloje Tomašević4,5, Slobodan Obradović6, Nemanja Stepanović7



University of Niš, Faculty of Medicine, Clinic of Cardiology, Niš, Serbia1

University of Niš, Faculty of Medicine,  Institute of Pathology, Niš, Serbia2

University of Niš, Faculty of Medicine, Institute of Forensic Medicine, Niš, Serbia3

Clinical Center Belgrade, Belgrade, Serbia4

University of Kragujevac,  Faculty of Medicine, Kragujevac, Serbia5

Military Medical Academy, Belgrade, Serbia

University of Niš, Faculty of Medicine, PHD study group, Niš, Serbia7


Coronary artery dissection is rare but very dangerous condition which can result in myocardial infarction. It mostly occurs in young postpartum women. The left anterior descending artery is affected in 75% of cases and in some extremely rare cases dissection may include all three coronary arteries. Treatment guides are still not consistent. While some authors recommend medical treatment other recommend surgical one. Case report. We present a 36-year-old female patient who was admitted to our hospital with intermittent chest pain and dyspnea that occurred two hours before admission. After premedication with Aspirin 300 mg per os, Clopidogrel 300 mg per os and Enoxaparin 30 mg iv, the pain disappeared. Chest pain was repeated after five days. Coronary angiography revealed spiral dissection in medial segment of LAD. After PCI attempt, dissection progressed and ended fatal. Pathological finding was intimal dissection of the coronary arteries with loss of some parts of internal elastic lamina.  It is interesting that in the literature there is no consistent opinion about therapeutic approach to SDCA and we hope that this case report will contribute to elucidating the problem. Acta Medica Medianae 2014;53(1):47-52.


      Key words: acute spontaneous coronary artery dissection, fibromuscular dysplasia, PCI treatment of SCAD