Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-015
Breaking Barriers: Overcoming Challenges in Addressing SCAD or Coronary Spasms in the Young Female
By Andi Yuniar Firmansyah, Hakim Alkatiri, Muzakkir Amir
Presenter
Andi Yuniar Firmansyah
Authors
Andi Yuniar Firmansyah1, Hakim Alkatiri2, Muzakkir Amir1
Affiliation
Hasanuddin University, Indonesia1, Wahidin Sudirohusodo Cardiac Centre, Indonesia2,
View Study Report
TCTAP C-015
Coronary - ACS/AMI
Breaking Barriers: Overcoming Challenges in Addressing SCAD or Coronary Spasms in the Young Female
Andi Yuniar Firmansyah1, Hakim Alkatiri2, Muzakkir Amir1
Hasanuddin University, Indonesia1, Wahidin Sudirohusodo Cardiac Centre, Indonesia2,
Clinical Information
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
a 37 years old women, admitted to the emergency department with significant acute onset chest pain during exercise, and had no significant coronary risk factors. Clinical Examination was unmarkable with BP 107/75 mmHg. An ECG at non PCI center revealed ST Elevation in leads I,aVL,V1-V3, and serial ECG at PCI center with only T inverted at V1-V3. Cardiac enzyme were elevated. She was diagnosed with STEMI anterior wall KILLIP I with spontaneous reperfusion.
Relevant Test Results Prior to Catheterization
Echocardiograhy bedside result with Normal LV systolic Function and Global Normokinetic. Hs Troponin I 20.247 ng/l
Relevant Catheterization Findings
Coronary angiography with conclusion coronary artery disease 1 vessel disease suspect spontaneous coronary artery dissection dd coronary spasm at LAD
Interventional Management
Procedural Step
A Coronary Angiography was performed, a direct incision to radialis artery under local anesthesia, insertion of sheat size 6F and begin canulation to left coronary artery and right coronary artery with Ultra 3.5 F catheter. Coronary angiography revealed that Left Main Normal, Diffused stenosis from mid to distal LAD, reduced intracoronary diameter compared to proximal segment, LCx Normal, RCA dominat vessel. The patient was adviced to undergo MSCTA Cardiac but the patient refused due to her financial reason.
Case Summary
The diagnosis of spontaneous coronary artery dissection is typically made by coronary angiography, but in this case, differentiating between an intramural dissection, atherosclerotic stenosis, or spasm may be challenging. The patient was suggested MSCTA Cardiac for further diagnostics, but unfortunately she refused due to financial reasons. For this challenging situation when dealing with chest pain, particularly in young healthy females who do not have any risk factors for atherosclerosis, suspicion of SCAD is crucial, so we decided to treat the patient using medical therapy instead of percutaneous coronary intervention.