article · Scholars Journal of Medical Case Reports
Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome that typically affects women and is often linked to physical or emotional stress. A case occurred in a thirty-year-old man who presented with three months of worsening exertional angina, leading to the discovery of extensive dissection in the left main and left anterior descending coronary arteries. The diagnosis was confirmed using coronary angiography alongside intravascular ultrasound. Aside from a history of tobacco smoking, the patient lacked major atherosclerotic risk factors, but had endured profound, sustained psychological distress following the death of his spouse a year earlier. Chronic emotional stress is identified as the probable trigger for the condition. The findings highlight the critical importance of reviewing psychosocial factors when assessing young patients with unexplained chest pain.
Spontaneous coronary artery dissection is frequently unexpected in young men who lack typical heart disease risk factors. Highlighting the physiological impact of severe, prolonged emotional stress on arterial health encourages medical professionals to investigate life stressors during routine assessments, ultimately improving timely diagnosis and tailored care for young individuals presenting with unexplained chest pain.
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Spontaneous coronary artery dissection (SCAD0 is a non-atherosclerotic cause of acute coronary syndrome that predominantly affects women, with emotional or physical stress recognized as one of its most consistent precipitating factors [1],[2]. We report a case of extensive SCAD, involving the left main coronary artery extending into the proximal-mid left anterior descending artery, in a 30-year-old man with a one-year history of widowhood and a background of tobacco smoking. He presented with three months of progressive exertional angina before diagnosis was confirmed on coronary angiography and intravascular ultrasound (IVUS). Given the absence of significant atherosclerotic risk factors beyond smoking, and the presence of sustained psychological distress following the loss of his spouse, chronic emotional stress is proposed as the most probable trigger in this case. This report discusses the pathophysiological link between emotional stress and SCAD, and argues for greater clinical attention to psychosocial history in young patients presenting with unexplained chest pain.
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DOI: 10.36347/sjmcr.2026.v14i08.020
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