CTICasesSpontaneous Coronary Artery Dissection and Incidental Anomalous Pulmonary Venous Return
Imaging findings
Coronary angiography demonstrates an abrupt, complete occlusion of the first obtuse marginal branch of the left circumflex artery, and cardiac CT shows a corresponding area of subendocardial hypoperfusion in the lateral left ventricular wall. Additionally, an incidental partial anomalous pulmonary venous return is identified, with an anomalous right upper lobe pulmonary vein draining directly into the superior vena cava.
Key takeaways
Spontaneous coronary artery dissection is an important cause of myocardial infarction in young to middle-aged women without traditional cardiovascular risk factors. While spontaneous coronary artery dissection typically presents on angiography as long-segment, smooth tapering, it can occasionally present as an abrupt vessel occlusion that mimics an embolic event or thromboembolism.
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