Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3095
Peer-review started: November 1, 2020
First decision: January 10, 2021
Revised: January 23, 2021
Accepted: February 22, 2021
Article in press: February 22, 2021
Published online: May 6, 2021
When autosomal dominant polycystic kidney disease (ADPKD) presents with acute coronary syndrome (ACS), the possibility of spontaneous coronary artery dissection (SCAD) should be highly considered. In some cases, SCAD is considered an extrarenal manifestation of ADPKD depending on the pathological characteristics of the unstable arterial wall in ADPKD.
Here, we report a 46-year-old female patient with ADPKD who presented with ACS. Coronary angiography revealed no definite signs of dissection, while intravascular ultrasound revealed a proximal to distal dissection of the left circumflex. After a careful conservative medication treatment, the patient exhibited favorable prognosis.
In cases of ADPKD co-existing with ACS, differential diagnosis of SCAD should be considered. Moreover, when no clear dissection is found on coronary angiography, IVUS should be performed to prevent missed diagnosis.
Core Tip: We report an acute chest pain patient with autosomal dominant polycystic kidney disease, the patient was ultimately diagnosed with spontaneous coronary artery dissection after a comprehensive intracoronary imaging. Therefore, coronary angiography and further intravascular imaging might be very essential for the diagnosis of autosomal dominant polycystic kidney disease accompanied by spontaneous coronary artery dissection.