Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3095-3101
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3095
Spontaneous coronary dissection should not be ignored in patients with chest pain in autosomal dominant polycystic kidney disease: A case report
Jun Qian, Yan Lai, Li-Jun Kuang, Fei Chen, Xue-Bo Liu
Jun Qian, Yan Lai, Fei Chen, Xue-Bo Liu, Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
Li-Jun Kuang, Department of Ultrasound, Luwan Branch, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200065, China
Author contributions: Qian J, Lai Y, Chen F and Liu XB were the patient’s cardiologists, reviewed the literature and contributed to manuscript drafting; Kuang LJ reviewed the literature and contributed to manuscript drafting; Qian J and Lai Y performed imaging findings; Chen F and Liu XB performed the diseases consultation, reviewed the literature and drafted the manuscript; all authors issued final approval for the version to be submitted.
Supported by The National Natural Science Foundation of China, No. 81670403; Grant of Shanghai Science and Technology Committee, No. 18411950300, No. 19XD1403300, and No. 19411963200.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Bo Liu, MD, Chief Doctor, Professor, Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, No. 389 Xincun Road, Putuo District, Shanghai 200065, China. 1911572@tongji.edu.cn
Received: November 1, 2020
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Spontaneous coronary artery dissection, Autosomal dominant polycystic kidney disease, Intravascular ultrasound, Case report

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.