{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:18Z","timestamp":1787008698309,"version":"build-2736575974"},"reference-count":4,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Excluding spontaneous coronary artery dissection (SCAD) as an aetiology of acute coronary syndrome in young adults is imperative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A previously healthy 39-year-old woman experienced sudden severe chest pain, ST-segment elevation on electrocardiogram, necessitating high-dose aspirin and urgent transfer to a revascularization centre. Suffering ventricular tachycardia (VT) and ventricular fibrillation (VF), she underwent two rounds of advanced life support and venoarterial extracorporeal membrane oxygenation. Diagnosed with left main coronary artery (LMCA) SCAD, she was initially started on conservative therapy for declining left ventricular ejection fraction. However, she continued to experience an escalating anginal symptoms, worsening biomarkers, and LMCA SCAD progression, which urged the need for surgical intervention with coronary artery bypass graft surgery (CABG). Following her CABG, she experienced a worsening of her functional mitral regurgitating, which she underwent transcatheter edge-to-edge repair of her severe mitral regurgitation. Despite being listed for orthotopic heart transplantation (OHTx), her low body mass index and elevated antibodies necessitated the HeartMate III left ventricular assist device (LVAD) for bridge to transplant. After treating frequent VT episodes with medications, she eventually received a LVAD as a bridge to cardiac transplantation. Within 1 year of her receiving LVAD, she underwent a successful OHTx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The pathogenesis of SCAD involves intramural haematoma formation through intimal tears or vasa vasorum haemorrhage. Adverse outcomes that could occur in SCAD patients include cardiac arrest, cardiogenic shock, reduced left ventricle systolic function, and occasionally serious cardiac arrhythmia\u2014such as VF\u2014which can lead to sudden cardiac death. Although most SCAD cases heal spontaneously, revascularization can be considered in case of worsening SCAD progression. Advanced therapeutic intervention including mechanical circulatory support and OHTx should be considered in refractory cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae234","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T11:13:10Z","timestamp":1714993990000},"source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous coronary artery dissection: a difficult journey from emergency coronary artery bypass grafting to left ventricular assist device"],"prefix":"10.1093","volume":"8","author":[{"given":"Daniel","family":"Ho","sequence":"first","affiliation":[{"name":"Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre , 2155 Rue Guy, Montr\u00e9al, QC H3H 2L9 , Canada"},{"name":"Division of Cardiology, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"DREAM-CV Laboratory, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Alfaris","sequence":"additional","affiliation":[{"name":"Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre , 2155 Rue Guy, Montr\u00e9al, QC H3H 2L9 , Canada"},{"name":"Division of Cardiology, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"DREAM-CV Laboratory, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"King Salman Heart Center, King Fahad Medical City , 2448, 6552, As Sulimaniyah, Riyadh 12231 , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-8888","authenticated-orcid":false,"given":"Abdulaziz","family":"Joury","sequence":"additional","affiliation":[{"name":"Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre , 2155 Rue Guy, Montr\u00e9al, QC H3H 2L9 , Canada"},{"name":"Division of Cardiology, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"DREAM-CV Laboratory, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"King Salman Heart Center, King Fahad Medical City , 2448, 6552, As Sulimaniyah, Riyadh 12231 , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzo","family":"Cecere","sequence":"additional","affiliation":[{"name":"Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre , 2155 Rue Guy, Montr\u00e9al, QC H3H 2L9 , Canada"},{"name":"Division of Cardiology, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"DREAM-CV Laboratory, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"Department of Cardiovascular and Thoracic Surgery, Heart Failure and Transplant Center, McGill University Health Center , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Giannetti","sequence":"additional","affiliation":[{"name":"Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre , 2155 Rue Guy, Montr\u00e9al, QC H3H 2L9 , Canada"},{"name":"Division of Cardiology, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"},{"name":"DREAM-CV Laboratory, McGill University Health Centre, McGill University , 1001 Bd D\u00e9carie, Montr\u00e9al, QC H4A 3J1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"2024052106211605100_ytae234-B1","doi-asserted-by":"crossref","first-page":"e523","DOI":"10.1161\/CIR.0000000000000564","article-title":"Spontaneous coronary artery dissection: current state of the science: a scientific statement from the American Heart Association","volume":"137","author":"Hayes","year":"2018","journal-title":"Circulation"},{"key":"2024052106211605100_ytae234-B2","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.jacc.2020.05.084","article-title":"Spontaneous coronary artery dissection. 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