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Rheumatology International

, Volume 39, Issue 10, pp 1821–1827 | Cite as

Spontaneous coronary artery dissection in systemic lupus erythematosus: case-based review

  • Bonifacio Álvarez-LarioEmail author
  • Laura Álvarez-Roy
  • Sandra Mayordomo-Gómez
  • Juan Marcos García-García
Case Based Review
  • 84 Downloads

Abstract

Patients with systemic lupus erythematosus (SLE) present an increased prevalence of coronary heart disease. The majority of cases of acute coronary syndrome (ACS) in patients with SLE are due to atherosclerosis. Less common causes include thrombosis of an angiographically normal coronary artery and coronary vasculitis. Spontaneous coronary artery dissection (SCAD) is a rare cause of ACS in these patients. We report the case of a 53-year-old female diagnosed of SLE presenting with an ACS caused by SCAD. She was treated medically and her clinical course was favorable. A literature search identified seven additional cases of SCAD associated with SLE. The main clinical features found in these reports are revised. ACS caused by SCAD in SLE patients is a condition likely under-reported in literature. SCAD should be suspected in patients with SLE and ACS, especially in younger women without evident cardiovascular risk factors. An early accurate diagnosis of SCAD is key to provide specific treatment, which differs from that of usual atherosclerotic ACS.

Keywords

Systemic lupus erythematosus Coronary artery disease Myocardial infarction Spontaneous coronary artery dissection 

Notes

Acknowledgements

The authors wish to thank the Research Unit of Hospital Universitario de Burgos (HUBU) for their help in the preparation of the English version of the manuscript.

Author contributions

The case was diagnosed and followed up by SMG, BAL and JMGG. BAL and LAR conceived and planned the study. BAL and LAR wrote the manuscript. Literature data were searched and analyzed by all the authors. The final version was read, corrected and approved by all the authors.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

All the procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All the authors fulfilled the ICMJE authorship criteria.

Informed consent

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Sección de ReumatologíaHospital Universitario de BurgosBurgosSpain
  2. 2.Cardiology DepartmentComplejo Hospitalario San Millán-San PedroLogroñoSpain
  3. 3.Cardiology DepartmentHospital Universitario de BurgosBurgosSpain

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