Spontaneous Multivessel Coronary Artery Dissection in a Middle-Aged Nigerian Male Patient With Chest Pain: A Case Report From Nigeria

Abstract

Spontaneous coronary artery dissection (SCAD) is now more frequently recognized as an etiology of acute coronary syndrome, primarily reported in women. Its occurrence in men remains rare and often goes unnoticed and underreported, especially in low- and middle-income countries like Nigeria, where limited access to advanced coronary imaging and low clinical suspicion hinder diagnosis. A 46-year-old Nigerian man was admitted with acute chest discomfort, T-wave abnormalities on electrocardiography and normal cardiac troponins. Coronary angiography showed multivessel spontaneous coronary artery dissection (SCAD) involving left anterior descending (LAD) and left circumflex (LCX) arteries. He was treated conservatively with good clinical outcome. SCAD should be considered in men with acute coronary symptoms, even when traditional cardiovascular risk factors are present. In Nigeria and similar resource-limited settings, maintaining a high level of suspicion and improving access to advanced cardiac diagnostics are essential for overcoming diagnostic challenges and providing appropriate, non-invasive treatment. To the best of our knowledge, following a comprehensive search of published literature, this represents the first described case of SCAD in a Nigerian male patient and one of the earliest cases documented in West Africa. The aim of this case report is to increase local awareness and promote a high index of suspicion for SCAD in men presenting with acute coronary syndrome, particularly in resource-limited settings.