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Electronic pages: case reports
A young woman with chest pain
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  • Published on: 9 January 2022
    Cystic media necrosis - Authors' response

    Dear Editor,

    We agree that cystic medial necrosis may in a small number of patients be the cause of spontaneous coronary artery dissection.[1] However, the pathogenesis of spontaneous coronary artery dissection remains poorly understood. Indeed, no uniform histological findings have been identified and it is improbable that a single mechanism operates in all these patients. Our patient had none of the featur...

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    Conflict of Interest:
    None declared.
  • Published on: 9 January 2022
    Cystic media necrosis
    Dear Editor,

    I was surprised that Missouris and colleagues in their case report failed to mention cystic medial necrosis as a cause of spontaneous coronary artery dissection.[1] This disease requires histologic confirmation and is characterised by focal fragmentation of elastic fibers, loss of smooth muscle cells of the media and the accumulation of acid mucopolysaccharides. Mandatory exclusion of Marfan syndrome, his...

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    Conflict of Interest:
    None declared.