AUTHOR=Huang Hongbo , Ma Xiaojuan , Xu Linjie , Wang Xin , Shi Dazhuo , Zhao Fuhai , Zhang Ying 

TITLE=Spontaneous coronary artery dissection and atherosclerosis in a young man with systemic lupus erythematosus: A case report and literature review

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.951188

DOI=10.3389/fcvm.2022.951188

ISSN=2297-055X

ABSTRACT=Background: Spontaneous coronary artery dissection (SCAD) is a rare coronary artery disease and frequently occurs in young, female patients without risk factors, and conservative treatment is often recommended in its management. The patient reported here is a male patient with systemic lupus erythematosus (SLE).
Case Summary: We describe a 28-year-old man with SLE who presented with an acute ST-segment elevation myocardial infraction (STEMI), was diagnosed with SCAD through a long dissection of the left anterior descending branch (LAD) by coronary angiography. He was treated with percutaneous coronary intervention (PCI) with stent implantation. Ten years later, he developed in-stent stenosis and other coronary atherosclerosis and was retreated with and PCIs. Based on this case and according to the literature review, the existing treatment and prognosis of SLE with spontaneous coronary artery dissection and atherosclerosis are discussed.
Conclusion: Cardiovascular complications should be considered in patients with systemic lupus erythematosus, although they may not initially be an atherosclerotic disease. Attention should be paid to distinguishing spontaneous coronary dissection in order to minimizing missed or delayed diagnoses and take appropriate managements, as well as the development of atherosclerosis in SLE patients, and timely intervention has a better prognosis.