# Spontaneous Coronary Artery Dissection Presenting as Electrical Storm: A Case Report

## TL;DR

A healthy 38-year-old man experienced a life-threatening heart rhythm due to a rare heart condition called spontaneous coronary artery dissection.

## Contribution

This case highlights electrical storm as a rare and severe presentation of SCAD in a young, healthy individual.

## Key findings

- SCAD can present as electrical storm in patients without traditional heart disease risk factors.
- Prompt diagnosis and stenting improved outcomes in this case.
- Emergency physicians should consider SCAD in young patients with ventricular arrhythmias.

## Abstract

Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction in patients of younger age without typical atherosclerotic risk factors and can present with ventricular arrhythmia such as ventricular tachycardia (VT) or ventricular fibrillation (VF). Electrical storm (ES) is defined as greater than or equal to 3 episodes of VT or VF occurring within 24 hours.

A healthy 38-year-old-male developed chest pain while exercising at the gym and presented to the emergency department unresponsive in a ventricular arrhythmia defined as ES. The patient’s cardiac arrest was initially refractory to standard defibrillation and Advanced Cardiac Life Support medications. He was ultimately diagnosed with SCAD of the left anterior descending artery, which was stented. The patient survived neurologically intact after a 13-day hospital stay.

Spontaneous coronary artery dissection is a significant cause of acute coronary syndrome and occurs in healthier patients without cardiac risk factors. Electrical storm represents a unique manifestation of SCAD. Emergency physicians should maintain a heightened suspicion for SCAD for accurate diagnosis and treatment.