Login
Search
Search
0 Dates
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Unveiling the Hidden Link: Fibromuscular Dysplasia Beyond Spontaneous Coronary Artery Dissection
Session:
MELHORES CASOS CLÍNICOS
Speaker:
Tatiana Pereira Dos Santos
Congress:
CPC 2025
Topic:
A. Basics
Theme:
02. Clinical Skills
Subtheme:
---
Session Type:
Sessão de Casos Clínicos
FP Number:
---
Authors:
Tatiana Pereira Dos Santos; Ana L. Silva; Sofia S. Martinho; Sílvia Monteiro; Francisco Gonçalves; Elisabete Jorge; José Luís Martins; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Introduction: Acute coronary syndromes (ACS) in young women without traditional risk factors are uncommon and often have unusual causes. A key cause is spontaneous coronary artery dissection (SCAD), frequently associated with fibromuscular dysplasia (FMD), a disease that alters the arterial structure, leading to stenosis, dissections, and aneurysms.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Clinical case: Female, 45 years old, with no known cardiovascular risk factors, presents to the emergency department with chest pain and an abnormal electrocardiogram showing ST elevation V3-V5 and inverted T waves. The high-sensitivity troponin had a peak of 5277 ng/L. Her only medication was a combined oral contraceptive pill. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Coronarography showed an acute coronary dissection of the anterior descending artery in the medial/distal segment with a spiral conformation, type 2. There was no coronary flow obstruction, and angioplasty was not performed. The computed tomography angiography (CTA) showed an extension of 66 mm of the dissection. The patient disclosed that her twin sister had died of an acute coronary infarction at age 36, and her mother had been diagnosed with a dissection of the descending aorta, suggesting a potential familiar cause. The patient had undergone thrombophilia screening in 2016, which was negative. Autoimmunity tests were also negative. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Due to the spiral conformation and family history, FMD diagnosis was suspected. In that sequence, a CTA was performed to screen for other arterial abnormalities in the thoracic, abdominal, and pelvic regions, as well as a head and neck scan. These studies showed an irregularity in the caliber of both external iliac arteries and the cervical portion of the left internal carotid artery, successive stenoses and dilatations, similar to a "string of beads" appearance, confirming multifocal FMD. No aneurysms were identified. At the time of discharge, the patient was asymptomatic with a good clinical evolution and a transthoracic echocardiogram with normal ejection fraction. Follow-up visits with cardiology, neurology, and vascular surgery were scheduled.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Discussion: This case underscores the importance of recognizing FMD as a potential underlying cause of SCAD, particularly in patients with a family history of premature cardiovascular events. The association between SCAD and FMD highlights the need for comprehensive vascular imaging. A team-based, multidisciplinary approach is essential for tailored treatment, and effective care of these complex conditions.</span></span></span></p>
Our mission: To reduce the burden of cardiovascular disease
Visit our site