Introduction
Spontaneous Coronary Artery Dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) and sudden death. It is defined as a separation within the coronary artery wall secondary to intramural hemorrhage, with or without tearing of the intima, thus modifying arterial architecture with the creation of a true and false channels. The starting point is often an intimal breach or even a hemorrhage of the vasavasorum [1]. SCAD preferentially affects the young population with almost no traditional cardiovascular risk factors and especially female with a sex ratio M / F of 1/5 [2]. It is responsible for 0.1 to 0.4% of all acute coronary syndromes [3]. It is an important cause of ACS in women and represents approximately 25% of acute coronary syndromes in women under 50 years old [4]. It has the same clinical presentation as acute coronary syndromes secondary to plaque ruptures. Many triggering factors are mentioned in the occurrence of a SCAD including physical or emotional stress [5].
Currently, the whole world experiences a very stressful condition generated by COVID-19 pandemic. Since the beginning of this pandemic, health care facilities precisely emergency room are overcrowded. So, with that massive influx of patients, many other diseases are misdiagnosed [6]. Xiang et al. in their study analysing the management and outcomes of patients with ST segment elevation myocardial infarction during the COVID-19 pandemic in China found an important decrease of the hospitalized patient with ST segment elevation myocardial infarction still the outbreak of COVID 19 pandemic. Also, they found a delay in management that patients according to the reperfusion strategy [6]. Similarly, Rashid et al . found a decline of acute myocardial infarction related hospitalization associated with a raise in the number of cases of out-of-hospital cardiac arrest since the beginning of this pandemic, particularly after the implementation of social confinement measures during the COVID-19 outbreak in England. Consequently, the reorganization of hospital services and staff in response to COVID-19 outbreak affected routine management of other diseases [7]. Through this case, we wanted to show the harmful influence of the current pandemic in the management of potential life-threatening issue as SCAD.