Is Carbon Monoxide Poisoning a Potential Trigger for Spontaneous Coronary Artery Dissection? A Case Report and Review of the Literature.
Selim Süleyman Sert, Sebahat Ulusan, Mevlüt Serdar Kuyumcu
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Case in brief
A 55-year-old woman developed altered mental status and respiratory failure after acute carbon monoxide poisoning from a domestic gas leak and received hyperbaric oxygen therapy. After stabilization, she developed typical anginal symptoms with rising cardiac biomarkers. Coronary angiography showed spontaneous dissections in the distal left anterior descending and distal right coronary arteries, without critical flow limitation. She was treated conservatively with medical therapy and remained asymptomatic at six-month follow-up.
What made this case unusual
SCAD was identified in two coronary arteries after acute carbon monoxide poisoning, an association the report describes as scarcely reported.
Diagnostic / clinical pearl
After carbon monoxide poisoning, new anginal symptoms and rising cardiac biomarkers warrant consideration of SCAD; coronary angiography in this case demonstrated dissections despite no critical flow limitation.