Spontaneous Coronary Artery Dissection


November 7, 2016

I am a physician and i had been out of work for several weeks with a febrile illness I was a healthy 63 year old man with a history of well controlled hypertension, but no other medical conditions. I developed a febrile illness with fevers to 103 and then cough and chest congestion. I was treated for influenza and then pneumonia. I developed significant bronchospasm and was hospitalized for that for 2 days.

While in the ER, a troponin level was drawn and it was mild elevated at 0.2. Normal at this lab was 0.08 and diagnostic was at 0.8. So I was in the gray area. I had follow up tests which all yielded the same result. I was discharged and recovered at home for two weeks with wheezing and coughing. Finally, I was ready to resume work.

The day I was to return, I felt vaguely unwell. I did not have wheezing, nor chest pain nor shortness of breath, just a feeling of foreboding. i called a cardiologist friend of mine and a cardiac catheterization was suggested. Two days later, I was having the procedure. I felt well. As I was having the procedure, the cardiologist told me that I had a hematoma with a 60% occlusion of the proximal left anterior descending artery. He was able to remove the hematoma and found the dissection. He was able to stent the dissection, though it was actively dissecting as he worked. Through all of this, I had no pain, no shortness of breath, no other symptoms. Fortunately, i was successfully treated and did not suffer any permanent cardiac damage, though at the time that the procedure was being done, my cardiogram showed ongoing ischemia.

Four days in the hospital and now six months later and I am finally getting back to normal I believe the 6 weeks of illness prior to this and then this episode have slowed my progress, but I am back to work, part time, and getting stronger.