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Spontaneous coronary artery dissection revealed by an iatrogenic spasm provocation test

Year: 2026

Type: article

Abstract: Spontaneous coronary artery dissection (SCAD) is an uncommon cause of MINOCA. The spontaneous development of an intramural hematoma narrows the true lumen. This narrowing may improve prior to coronary angiography, or may not be appreciated, leading to a diagnosis of MINOCA. We reported the case of a 50-years old woman, active smoker, with a previous history of MINOCA [septo-apical MI on Cardiac Magnetic Resonance (CMR) imaging] who was referred to our institution for recurrent chest pain. Two coronary angiograms, which were previously performed, were considered as normal. We decided to repeat coronary angiography in order to perform a spasm provocation test. Unfortunately, this test during this third examination induced recurrent chest pain and revealed a SCAD.

Source: European Heart Journal - Case Reports

DOI: 10.1093/ehjcr/ytag792

Authors: Edouard Gerbaud, Hubert Cochet, Soumaya Sridi-Cheniti