CTICasesSpontaneous Coronary Artery Dissection (SCAD)
Imaging findings
CT angiography of the chest, abdomen, and pelvis demonstrates normal extra-cardiac arteries with no signs of fibromuscular dysplasia. However, delayed-phase imaging incidentally depicts a localized zone of myocardial hyperperfusion/enhancement along the lateral free wall of the left ventricle.
Key takeaways
Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction in young, postpartum women, often associated with systemic arteriopathies like fibromuscular dysplasia. While coronary evaluation is typically performed via invasive angiography or dedicated cardiac CT, standard delayed-phase CT of the chest or abdomen can occasionally capture areas of myocardial injury or infarction that are less conspicuous on early arterial phase scans.
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