Introduction
Spontaneous Coronary Artery Dissection (SCAD) is a rare cause of acute
coronary syndrome (ACS) and sudden death. It is defined as a separation
within the coronary artery wall secondary to intramural hemorrhage, with
or without tearing of the intima, thus modifying arterial architecture
with the creation of a true and false channels. The starting point is
often an intimal breach or even a hemorrhage of the vasavasorum [1].
SCAD preferentially affects the young population with almost no
traditional cardiovascular risk factors and especially female with a sex
ratio M / F of 1/5 [2]. It is responsible for 0.1 to 0.4% of all
acute coronary syndromes [3]. It is an important cause of ACS in
women and represents approximately 25% of acute coronary syndromes in
women under 50 years old [4]. It has the same clinical presentation
as acute coronary syndromes secondary to plaque ruptures. Many
triggering factors are mentioned in the occurrence of a SCAD including
physical or emotional stress [5].
Currently, the whole world experiences a very stressful condition
generated by COVID-19 pandemic. Since the beginning of this pandemic,
health care facilities precisely emergency room are overcrowded. So,
with that massive influx of patients, many other diseases are
misdiagnosed [6]. Xiang et al. in their study analysing the
management and outcomes of patients with ST segment elevation myocardial
infarction during the COVID-19 pandemic in China found an important
decrease of the hospitalized patient with ST segment elevation
myocardial infarction still the outbreak of COVID 19 pandemic. Also,
they found a delay in management that patients according to the
reperfusion strategy [6].
Similarly, Rashid et al . found a decline of acute myocardial
infarction related hospitalization associated with a raise in the number
of cases of out-of-hospital cardiac arrest since the beginning of this
pandemic, particularly after the implementation of social confinement
measures during the COVID-19 outbreak in England. Consequently, the
reorganization of hospital services and staff in response to COVID-19
outbreak affected routine management of other diseases [7]. Through
this case, we wanted to show the harmful influence of the current
pandemic in the management of potential life-threatening issue as SCAD.