Plaque erosion masquerading as spontaneous coronary artery dissection: A case of sudden coronary death
Journal of cardiovascular computed tomography
Acute coronary syndrome; CCTA; Coronary thrombosis; Napkin ring sign; PIT; Plaque erosion; SCAD; Sudden coronary death
The three most common mechanisms of thrombosis in acute coronary syndrome (ACS) are plaque rupture, plaque erosion and calcified nodule. Plaque erosion occurs over an intact fibrous cap, commonly over pathological intimal thickening (PIT) rather than thin cap fibroatheroma (TCFA), and is more common among younger and female patients. A very rare mechanism of ACS is spontaneous coronary artery dissection (SCAD), resulting from the formation of an intramural hematoma and/or intimal disruption. We present a case of sudden coronary death with the appearance of SCAD on coronary computed tomography angiography (CCTA).
Tantawy, Sara W.; Gianni, Umberto; Sato, Yu; Amoa, Falone C.; Shaw, Leslee J.; Fowler, David; Min, James K.; Earls, James P.; Finn, Aloke; Virmani, Renu; and Lin, Fay Y., "Plaque erosion masquerading as spontaneous coronary artery dissection: A case of sudden coronary death" (2022). GW Authored Works. Paper 673.