Coronary Heart Disease (CAD) Community
coronary artery dissection treatment
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Coronary Heart Disease (CHD) (aka: Coronary Artery Disease (CAD); Atherosclerosis; is the leading cause of death worldwide. It is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle. Over time, CHD can weaken the heart muscle and lead to heart failure or irregular heart rhythms (arrhythmia). The purpose of the community is to share support and information with Coronary Heart Disease patients, their loved ones, and caregivers.

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coronary artery dissection treatment

I am a 46 year old female and had a spontaneous dissection of the OM1 branch of the circumflex artery one month ago, with approximately 90% occlusion and a 5-10% infarction.  This in my opinion was chronic and intermittent for about three years  with a negative workup until it came to a full blown ischemic event  a month ago.  I have had two opinions stating it is not safe to stent and not feasable to bypass.  I had a positive setsamibi stress test last week showing ongoing ischemia.  I continue to have pain particularily with exercise but also at rest.  I am on Coreg as well as Isodur, aspirin, and Zocor for inflamation (inflammation) (I have a total cholesterol of 150 and HDL of 80).  I am otherwise healthy, no family history, have a BMI of 18, and have run numerous marathons.  

What is your opinion as to available treatment?    
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Ann, I had a spontaneous dissection of the RCA repaired successfully with a non-stented 3.5 X 25 mm stent.  I had an 85% occlusion.  The procedure took a long time, I'm told, I just have fleeting memories but I do know it was a difficult procedure.  I take Coreg, Plavix, Hctz, Altace, 81 mg aspirin and Vytorin.
My Cardiologist confirmed the comment from the doc responding to the Interventional Cardiology section of this forum that it was probably caused due to location between two earlier stents, it set up a spasm of some sort.  
I certainly know nothing, I'm just a fellow heart patient, but I know that  a spontaneous dissection is generally considered a serious condition.  I'd consider another opinion if that is possible to you, especially if the two opinions you have are from doctors in the same hospital.  Others on this site might be able to guide you how to have your records sent to a place like the Cleveland Clinic or other top-notch cardiac hospital/research center, I don't know how that is done.
Good luck, I hope you find a solution.  I'm going to monitor your posting hoping to hear something postitive from you.  
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