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Rituximab Associated Non-Atherosclerotic Spontaneous Coronary Artery Dissection

This is a case of idiopathic NA-SCAD (non-atherosclerotic spontaneous coronary artery dissection) occurring in a patient receiving rituximab chemotherapy for stable Stage IV follicular lymphoma. This patient experienced typical angina relieved with nitroglycerin. A diagnosis of non-ST segment elevation myocardial infarction secondary to NA-SCAD was made based on invasive coronary angiography features and cardiac magnetic resonance (CMR) imaging. The association between NA-SCAD and rituximab therapy has been previously described in various case reports. In the absence of identifiable precipitating factors, NA-SCAD secondary to rituximab is probable.

Author(s): Rouse J, Haller CF, Vande Hei AG and Thomas DM

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