Plaque erosion masquerading as spontaneous coronary artery dissection: A case of sudden coronary death

Authors

Sara W. Tantawy, Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; Department of Radiology, Ain Shams University Hospitals, Cairo, Egypt. Electronic address: swt4001@med.cornell.edu.
Umberto Gianni, Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
Yu Sato, Department of Pathology, CVPath Institute, Gaithersburg, MD, USA.
Falone C. Amoa, Department of Pathology, CVPath Institute, Gaithersburg, MD, USA.
Leslee J. Shaw, Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
David Fowler, Office of the Chief Medical Examiner, Baltimore, MD, USA.
James K. Min, Cleerly, Inc, New York, NY, USA.
James P. Earls, Cleerly, Inc, New York, NY, USA; Department of Radiology, George Washington University School of Medicine, USA.
Aloke Finn, Department of Pathology, CVPath Institute, Gaithersburg, MD, USA.
Renu Virmani, Department of Pathology, CVPath Institute, Gaithersburg, MD, USA.
Fay Y. Lin, Dalio Institute of Cardiovascular Imaging, Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.

Document Type

Journal Article

Publication Date

3-1-2022

Journal

Journal of cardiovascular computed tomography

Volume

16

Issue

2

DOI

10.1016/j.jcct.2021.10.001

Keywords

Acute coronary syndrome; CCTA; Coronary thrombosis; Napkin ring sign; PIT; Plaque erosion; SCAD; Sudden coronary death

Abstract

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).

APA Citation

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.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/673

Department

Radiology