Correct!
5. All of the above
Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome with a spectrum of clinical presentations ranging from chest pain to ST-elevation myocardial infarction to ventricular fibrillation and sudden death (4). It typically affects a younger, otherwise healthy, female population. Initial mortality is fairly low, however ten-year rates of major adverse cardiac events is estimated at 47%. Fibromuscular dysplasia, connective tissue disorders such as Ehlers-Danlos or Marfan syndrome, and cocaine use have all been associated and are potentially causative factors.
Surgical versus medical management was discussed. Percutaneous intervention carried too great a risk for further progression of the dissection. Coronary artery bypass graft surgery carried a high risk of early graft failure due to competitive flow. Given these potential complications, medical management was pursued.
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