Myocardial infarction in a 21-year-old patient: Spontaneous coronary artery dissection

Abstract

A 21-year-old male consulted for precompetitive evaluation with a history of consulting 4 years before for precordial pain of anginal characteristics. The electrocardiogram evidences previous anterior myocardial necrosis for which a previous coronary event is suspected. A complementary battery of studies corresponding to ischemic cardiopathy begins, including cinecoronariography, which shows a chronic lesion compatible with spontaneous dissection of the anterior descending artery. Based on these findings, myocardial viability is investigated, which is negative, so medical treatment and implantable cardio-defibrillator placement are instituted for increased risk of sudden death.