Spontaneous Coronary Artery Dissection (SCAD) Presenting as Non-ST Elevation Myocardial Infarction (NSTEMI) During Menstruation in a Hypertensive Woman: A Case Report of Menstrual Hormonal Fluctuations as a Potential Trigger

Spontaneous coronary artery dissection (SCAD) is an uncommon, non-atherosclerotic cause of acute coronary syndrome (ACS) that primarily affects younger women. We describe the case of a 33-year-old woman with hypertension who presented with acute chest pain during menstruation and was diagnosed with SCAD by coronary angiography. Hormonal fluctuations during the menstrual cycle have been postulated to contribute to the pathogenesis of SCAD through transient alterations in vascular wall integrity and arterial stability in susceptible individuals. This report highlights the need for heightened clinical suspicion of SCAD in young women presenting with chest pain, particularly in the presence of hypertension and potential hormonal triggers.