SCAD -- an underrecognised cause of ACS in the "low risk" young female patient. Management differs to atherosclerotic MI, with conservative therapy the mainstay.
A 36 year old man has just completed a marathon. He develops chest heaviness, shortness of breath, nausea and feels dizzy and faint. He has no known past medical history and considers himself to be in excellent health, regularly competing in long distance running events.
Cocaine is a recreational drug with sympathomimetic effects in additional to being a sodium channel blocker. Cocaine can induce acute coronary syndromes through vasoconstriction, atheroma rupture and/ or dissection
The approach to non-traumatic chest pain requires the early recognition and exclusion of potential life threats, then further consideration of other causes.
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