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The fear of being without a mobile phone, known as nomophobia, is a new psychological issue that has arisen with the widespread use of information and communication technologies. To understand this phenomenon, more research is needed. The present study aimed to assess the factor structure of the Moroccan dialect version of the Nomophobia Questionnaire (NMP-Q) among a sample of Moroccan university students. The study included 400 students selected by convenience sampling from two universities (Fez and Rabat). First, an Exploratory Factor Analysis (EFA) was conducted using the principal component method with Varimax rotation. Then, a Confirmatory Factor Analysis (CFA), and Exploratory Structural Equation Modeling (ESEM) were carried out. The results showed that a 20-item, four-factor model was the best fit for the data collected from the sample, indicating cross-cultural validity and the robustness of the NMP-Q's structure. This suggests that the Moroccan version of the NMP-Q is useful for assessing nomophobia behavior among Moroccan university students.

Introduction: Galectin-3 is a β-galactoside-binding lectin with several roles in the immune- inflammatory response. The aim of this systematic review and meta-analysis was to explain the prognostic value of Galectin-3 on COVID-19 severity and mortality from the existing literature. Methods: PubMed/MEDLINE, EMBASE, SCOPUS, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were surveyed up to November 10, 2023, for studies reporting data on Galectin-3 levels and the severity and mortality of patients with COVID-19. We performed frequentist random-effects network meta-analysis and presented the standard mean difference (SMD) and 95% confidence interval (CI). Results: Galectin-3 levels among patients with and without COVID-19 varied with the following values: 15.73±13.03 vs. 8.72±5.82 pg/mL, respectively (SMD = 2.59; 95%CI: 1.52 to 3.67; p

Introduction: In recent years, there has been a growing focus on assessing life satisfaction among students, as a way of measuring their overall wellbeing. This study aims to investigate how positive feelings (PF) and negative feelings (NF) predict academic performance (AP) through time management (TM) as a mediator in this process. Methods: This cross-sectional study was conducted among Moroccan students from the University of Sidi Mohamed ben Abdullah in Fez. A total of 540 students (288 females, 53.3%; 252 males, 46.7%; with a mean age of 21.51 and a standard deviation of 3.86) completed a pencil and paper questionnaire. A questionnaire was adopted as a tool in this research. Positive emotions (Pe), Negative emotions (Ne), and Life satisfaction were measured on a five-rank scale for each variable (strongly agree = 5, strongly disagree = 1). Results: The results of using structural equation modeling showed that the life satisfaction factor, which includes two dimensions, PF and NF, has a significant influence on academic performance. Discussion: Creating a supportive and positive learning environment can enhance students' wellbeing and improve academic performance.

Introduction: People encounter many events across their life span. However, some life experiences cause negative psychological outcomes. One of them is earthquakes. Therefore, in this study, it was aimed to examine the mediating role of peritraumatic distress in the relationship between childhood psychological maltreatment and optimism and pessimism among earthquake survivors. Methods: Using a snowball sampling technique with a cross-sectional research design, the sample comprised 311 adults who survived earthquake survivors in Turkey. Participants ranged in age between 18 and 61 years (mean age = 27.57±8.03). Of the participants, 231 (74.3%) were females and 80 (25.7%) were males, and they completed the Psychological Maltreatment Questionnaire–Short Form, Peritraumatic Distress Inventory, and Optimism and Pessimism Questionnaire. Results: The findings showed that childhood psychological maltreatment was positively related to peritraumatic distress and pessimism, and negatively related to optimism. Similarly, peritraumatic distress was positively related to pessimism and negatively related to optimism. More importantly, peritraumatic distress mediated the relationship between childhood psychological maltreatment and optimism and pessimism. These findings highlight the importance of addressing peritraumatic distress as an important factor in improving individuals’ perspectives on life. Discussion: Implementing tailored interventions to mitigate peritraumatic distress could lead to a more optimistic mindset and reduced levels of pessimism. By providing individuals with effective coping strategies and support systems, such interventions may empower them to overcome the challenges posed by stressful situations and cultivate a more positive outlook on life.

Introduction: To investigate the role of environmental conditions, knowledge, attitudes, and control measures of preventive behaviors in cutaneous leishmaniasis (CL) based on the BASNEF model in patients who were referred to the health care centers of cities hit by earthquakes, including Sarpol-Zahab and Qasr-Shirin located in Kermanshah province, Western Iran, in 2021. Method: In this descriptive cross-sectional study, 128 individuals who visited rural and urban health centers were randomly selected, then they were asked to fill in a structured questionnaire with questions about their demographic information, environmental conditions, knowledge, attitude, and preventive behavior regarding CL. Results: Approximately 89.1% of the individuals used urban water supply networks, while 68% of the participants had access to the wastewater collection system. The most influential people in preventive behaviors (control actions) were family members (72.4%). Pearson’s correlation test showed that preventive behaviors positively correlated with understudy variables in the BASNEF model (p

Background: Amidst the COVID-19 pandemic and the implementation of home confinement measures, understanding the psychological well-being of individuals has become crucial. Aim: This study examines the irregular effects of gender, age, marital status, and educational level on the psychological well-being of the Moroccan population during COVID-19 home confinement. Design: A cross-sectional study design was utilized. Setting: The study was conducted online, with participants residing in Morocco. Population: The study included individuals from the Moroccan population (n=1.051) who experienced home confinement during the COVID-19 pandemic. Methods: Data was gathered through an anonymous psychological well-being scale administered online. Results: Data analysis revealed three underlying traits: The first is the unexpected impact of age, gender, education levels, and marital status on certain well-being parameters. The second is the varied impact of gender, specifically in its interaction with age and marital status. The varied impact was also reflected in the participants’ mean scores across the well-being parameters. The third indicator revealed the nonlinear impact of the education level on some well-being parameters. Conclusion: The study drew the attention of public health decision-makers to the need to include different scenarios in the elaboration of anticipatory plans in the case of a new pandemic and to avoid sticking to regular models based on regular scenarios only.

Introduction: Burnout syndrome (BOS) among healthcare workers (HCWs) is a widespread phenomenon that leads to poor staff health and diminished quality of medical care. Spirituality has been proposed as a coping strategy against BOS. The relationship between spirituality and BOS needs to be evaluated. Therefore, a systematic review was conducted to synthesize evidence for understanding association between spirituality and BOS. Methods: The PRISMA guidelines were used to conduct a systematic search of bibliographical databases, including PubMed/Medline, Scopus, and several others in June 2022. Titles. Abstracts, and full-texts of all articles were screened to determine eligibility. The National Heart, Lung, and Blood Institute (NHLBI) quality assessment tool was utilized for the risk of bias (RoB) assessment. Pertinent data were collected using a standardized codebook. Results: Of the original 217 studies, 26 were included in the systematic review, with a total sample of 8,666 participants. Only five studies were interventional or experimental, while the remaining were cross-sectional. Most studies indicated a positive relationship between spiritual well-being or spirituality and personal accomplishment, and a negative association with emotional exhaustion and depersonalization. Interventional studies found that spirituality-based interventions were effective in reducing BOS among HCWs, however, the evidence is fairly scarce. Discussion and Conclusions: There is weak evidence that spirituality is inversely associated with BOS. There are insufficient evidence that spiritual-based health promotion programs in the workplace may be effective in preventing and/or reducing BOS in HCWs.

Introduction: As the major mechanism for coronavirus disease 2019, cytokine storm-mediated organ harm continues to dominate current understanding. Despite the first hyper-inflammatory phase, emerging data show that virus-induced poor host immunity may be the true cause of mortality in many individuals. Interleukin 7 (IL-7) is an interleukin that participates in the COVID-19 cytokine storm and regulates the immune system. Its role in COVID-19 cytokine storms is thought to be related to its ability to stimulate the formation and activation of immune cells such as T cells and B cells. This meta-analysis aims to determine the relationship, if any, between interleukin-7 and COVID-19 severity. Methods: This study was planned as a systematic review and meta-analysis and followed the PRISMA guidelines. Four main electronic databases (Web of Science, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials) were searched from January 1st, 2020 to September 2nd, 2022, to find papers investigating the prognostic significance of interleukin-7 in COVID-19-hospitalized adults. Google Scholar was used in addition to the online database search. A random effects model was used to calculate mean differences and 95% confidence interval (CIs) as well as the I2 statistics for heterogeneity analysis. Results: Seven papers were chosen for meta-analysis findings synthesis. All six trials reported interleukin-7 levels among severe and non-severe COVID-19 patients. Pooled analysis showed that IL-7 levels in the severe group were 62.79Б}81.03 pg/mL, compared to 33.39Б}56.54 pg/mL for the nonsevere group (SMD = -0.17; 95%CI: -0.93 to 0.60; p=0.67). Discussion: Available evidence suggests that elevated levels of IL-7 were not associated with the disease severity of COVID-19. While IL-7 levels alone may not have a substantial impact on COVID-19 severity, the interaction between IL-7 and other cytokines, immune cells, and variables such as viral load and genetics should be investigated further.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) caused a new coronavirus disease (COVID-19), which is highly contagious and its pathogenesis has not been fully elucidated. In COVID-19, the inflammation and blood coagulation systems are excessively activated. SARS-CoV-2 damages endothelial cells and pneumocytes, which leads to disruption of hemostasis in SARS. Thromboembolism is the main cause of mortality in patients with COVID-19. Clots, including pulmonary embolism (PE) and deep vein thrombosis (DVT), ranging from minor to fatal complications of the SARS-CoV-2 infection are known. Individuals with pre-existing diseases are more susceptible to the development of blood clots and poor outcomes. High levels of circulating cytokines and D-dimer (DD) are influential biomarkers of poor outcomes in COVID-19. The latter occurs as a result of hyperfibrinolysis and hypercoagulation. Plasmin is a key player in fibrinolysis and is involved in the cleavage of many viral envelope proteins, including SARS-CoV. Due to this function penetration of viruses into the host cell occurs. In addition, plasmin is involved in the pathophysiology of acute respiratory distress syndrome (ARDS) in SARS and promotes the secretion of cytokines, such as IL-6 and TNF, from activated macrophages. The focus of existing treatment to alleviate fibrinolysis in patients with COVID-19 is the use of systemic fibrinolytic therapy given thrombotic pathology in severe forms of COVID-19 which may lead to death. However, fibrinolytic therapy may be harmful in the advanced stages of COVID-19, when the status of disseminated intravascular coagulation (DIC) changes from suppressed fibrinolysis to its enhancement during the progression of the disease. This narrative review aims to elucidate the pathogenesis of COVID-19, which will further help in precise diagnosis and treatment.

Introduction: Emotional well-being is a key ingredient of well-being and positive mental health. Resilience and perceived social support have been found to be important factors influencing emotional well-being. Age, gender, and personality traits have also been suggested as potential predictors of emotional well-being. However, it is unclear to what extent resilience and perceived social support predict emotional well-being after controlling for these variables among Saudi adults. Therefore, this study aims to examine the unique contribution of resilience and perceived social support in predicting emotional well-being while controlling for age, gender, and personality traits. Methods: The participants were young Saudi adults (83.64% females) whose ages ranged from 18 to 60 years, with a mean age of 32.37 (SD = 8.64). They completed an online survey comprising the Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, Scales of Positive and Negative Experiences, Ten-Item Personality Inventory, and a socio-demographic questionnaire. Results: The results showed that after controlling for age, gender, and personality traits that showed an influence on emotional well-being, resilience and perceived social support exerted a statistically significant influence on the emotional well-being of international young adults by explaining a significant amount of unique variance. Discussion: The findings of this study provide important insights into the factors that contribute to emotional well-being among young Saudi adults. The findings suggest that the development of effective interventions and programs aimed at promoting emotional well-being among young Saudi adults should focus on enhancing resilience and perceived social support.

A ntimicrobial resistance (AMR) occurs when microorganisms such as bacteria, viruses, fungi and parasites change in ways that render the medications used to cure the infections they cause ineffective [1]. AMR is a significant global public health concern [2]. Low-quality medicines, wrong prescriptions and poor infection prevention and control, as well as lack of government commitment and poor surveillance are also hindering the control of antimicrobial drug resistance [1, 3]. As AMR undermines the achievement of the UN’s Sustainable Development Goals, the World Health Organization (WHO) called for a coordinated action among all countries worldwide, giving a special role to their governments [2, 4]. According to the European Centre for Disease Prevention and Control (ECDC) country visit to Italy in 2017, the Antimicrobial resistance (AMR) situation in Italian hospitals and regions poses a major public health threat to the country. The levels of carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii have now reached hyper-endemic levels and, together with meticillin-resistant Staphylococcus aureus (MRSA), this situation causes Italy to be one of the Member States with the highest level of resistance in Europe [5, 6]. Recently, a large outbreak of New Delhi metallo-beta-lactamase (NDM)-producing carbapenem-resistant Enterobacteriaceae (CRE) has been reported from the Tuscany region in Italy, where 9 Tuscan hospitals notified, from 1 November 2018 to 23 May 2019, a total of 350 cases, including those related to asymptomatic carriers. As a consequence, all hospitals in Tuscany have strengthened prevention and control measures against this infection [7]. NDM is a metallo-beta-lactamase able to hydrolyse almost all beta-lactams, including carbapenems [8]. Since its first description in 2008 from a Klebsiella pneumoniae strain isolated from a patient repatriated to Sweden after hospitalisation in New Delhi, India, NDM-positive strains have been identified worldwide, with the highest prevalence in the Indian subcontinent, causing healthcare-associated outbreaks worldwide [5]. Risk factors for acquisition of carbapenemase-producing CRE, including those producing NDM, include recent admissions to healthcare facilities, especially in regions with a high CRE prevalence, residence in long-term care facilities, surgical procedures and indwelling devices, as well as intensive care therapy and long duration of hospitalization [9, 10]. Since its first identification in 2009, the prevalence of the blaNDM gene has continuously increased worldwide [11]. Klebsiella pneumoniae and Escherichia coli are the predominant carriers of blaNDM [8], but the source of infection remains unknown [12]. This outbreak in Italy is one of remarkable importance, because NDM-producing carbapenem-resistant Enterobacteriaceae (CRE) are not susceptible to some of the new beta-lactam/beta-lactamase inhibitor combinations such as ceftazidime-avibactam and meropenem-vaborbactam, thus reducing the treatment options. Furthermore, as Klebsiella Pneumoniae carbapenamase (KPC)-producing CRE is already endemic in Italy and Tuscany is a highly touristic area, therefore the risk for spread to European healthcare facilities of NDM-producing CRE from the current outbreak is high [12]. For this reason, as suggested by ECDC [5], Italian stakeholders should timely take actions to prevent transmission in healthcare facilities for preventing transmission from CRE-positive patients and preventing spread of CRE in specific wards/units, as well as they should take actions to prevent cross-border spread. The Tuscany region has implemented a specific epidemiological surveillance. According to its Agenzia Regionale di Sanità (ARS) data, between November 2018 and 27 October 2019, NDM producing CREs have been identified in the blood of 129 patients and the rate of mortality in patients with sepsis was as 33% [13]. Tuscany has an effective antibiotic resistance monitoring system (SMART network) [14], but in Italy systems for surveillance of AMR at regional level are only in place in a few regions. Indeed, there are two sentinel networks at national level, named AR-ISS and MICRONET, but there is an unequal, geographical distribution of the hospital laboratories that participate in AR-ISS and MICRONET, which are mostly located in the northern regions, despite the fact that AMR prevalence is acknowledged to be highest in the central and the southern regions of the country. Moreover, as highlighted by the ECDC Report, at local hospital level, surveillance of AMR tend to be unstructured and lacking focus in the keys areas of interest, and not all hospitals have an on-site microbiology laboratory supported by a microbiologist, as well as not all microbiology units of laboratories are run by a medical doctor. The different accreditation system of laboratories among Italian regions, furthermore, hinders the process of building up an effective comprehensive monitoring system at national level [5]. This complicates the implementation of the recent guidelines suggested by ECDC and requires prompt action by Italian policymakers. Otherwise, the first Italian National Action Plan on Antimicrobial Resistance (PNCAR) 2017–2020 [15], which represents the tool needed to implement the Italian strategy, could be ineffective.

Acute hypokalaemic paralysis is a rare but treatable cause of acute limb weakness. Thyrotoxic paralysis is an uncommon, potentially life-threatening endocrine emergency and it is a rare complication of hyperthyroidism. The most common causes of hyperthyroidism include Graves’ disease, multinodular goiters or solitary thyroid nodule, and iodine-induced thyrotoxicosis (Jod-Basedow syndrome). Thyreotoxicosis factitia, which is caused by the excessive ingestion of exogenous thyroid hormone or iodine derivatives administration, has been rarely reported as a cause of thyrotoxic paralysis. We describe the case of a young Caucasian male with flaccid paralysis of all four limbs and severe hypokalaemia after inappropriate iodine derivatives (iodocasein) intake to show, in conclusion, how critical care physicians need to be aware of this rare but curable condition.

Introduction: Sepsis is one of the most deadly and costly conditions at hospitals. Our study aimed to study levels of knowledge and attitudes in management of sepsis among nurses and physicians employed at Fatebenefratelli hospital, Milano, North-Italy, with particular regard to the analysis of the effects of educational training. Methods: A cross-sectional, quasi-experimental study was conducted between June 1 and October 30, 2017. Physicians and nurses from Intensive Care Unit (ICU) and non-ICU hospital wards were recruited. The study participants were invited to attend some educational workshops and, after 6 months, to fill out a questionnaire based on the 2016 Surviving Sepsis Campaign guidelines. Descriptive statistics were expressed with frequency and percentage (%). Chi-square and Student’s t-test were performed to compare the differences in awareness and knowledge between groups. P-values < 0.05 were considered statistically significant. Results: Nurses and physicians reported both ‘good’ levels (> 75%) of knowledge of procedures that increase risk of sepsis, ‘fairly‘ (50-75%) levels of knowledge, attitudes and behaviour towards blood culture techniques, and ‘poor’ (< 50%) levels of knowledge concerning early identification, methods and scores for diagnosis and management of sepsis. However, with regard to this latter point, T Student test for sample independent confirmed a significant difference in the average percentages of correct answers between recently (~ 6 months) trained (74 ± 3.4%) nurses (n = 33) and physicians (n = 19) and not recently (> 1 years) or never trained (34.8 ± 7.4%) nurses (n = 99) and physicians (n = 30) (t(10) = 11.72, P = < 0.001). Discussion and Conclusion: Our findings showed that levels of knowledge concerning methods and scores for early identification of sepsis can be significantly improved by educational training. A good knowledge of sepsis guidelines is essential to correct management of this condition.

A 52-year-old female, nonalcoholic, with no significant past medical history, was empirically treated with intravenous administration of levofloxacin (LVFX, 750 mg/day) for bronchopneumonia. On day 2, she reported seeing people who are not there (visual hallucinations). She had no history of psychiatric disorders or any family history of mental illness. The patient underwent EEG and brain magnetic resonance imaging (MRI), which resulted normal. Hence, psychiatric and neurological examinations excluded delirium, encephalitis, meningitis, structural neurological lesions. Any endocrine dysfunction (e.g., hypoglyvemia, dyselectrolytemia, diabetic ketoacidosis) or toxic ingestion were also excluded. However, the possibility of levofloxacin-induced acute psychosis was considered and, on day 3, levofloxacin was discontinued with a complete resolution of the patient’s visual hallucinations by her sixth day of hospitalization. The Naranjo Probability Scale (NPS) for determining the likelihood of whether an adverse drug reaction (ADR) is actually due to the drug rather than the result of other factors was calculated as + 6 (‘probable’). In literature, the association between psychiatric adverse events and assumption of fluoroquinolones is known, but only a few cases after assumption of levofloxacin have been reported. However, the true prevalence of levofloxacininduced neuropsychiatric adverse effects could be underestimated. Therefore, physicians and psychiatrists should consider neuropsychiatric adverse effects when prescribing levofloxacin or other fluoroquinolones.

The patient was an 80-year-old man who arrived at the emergency room with breathing problems. He presented a history of chronic obstructive pulmonary disease (COPD), hypertension, diabetes mellitus and early (stage 1) chronic renal failure with normal levels of creatinine and no sign and symptoms of renal disease. A chest X-ray showed pneumonia. Therefore, he was first treated with 1 g daily of ceftriaxone IV. We did not observe any clinical improvement, and for this reason, a sputum culture was performed to guide the right antibiotic treatment. Subsequently, we started a new antibiotic therapy with trimethoprim/sulfamethoxazole (TMP/SMX) adjusted to renal functioning. Appropriate medical treatment was administered, as well as urine alkalinisation. After the first day of treatment, the patient’s clinical and laboratory status worsened very quickly, with an increased level of serum creatinine from 1.5 to 3.5 mg/dL. We stopped administering the antibiotic therapy immediately. However, we observed acute renal failure with a serum creatinine level of 9.0 mg/dL and four days after his admission, the patient died. Literature showed that patients can develop acute kidney injury (AKI) during or immediately following TMP/SMX therapy. Intrinsic renal impairment –rather, interstitial nephritis– appeared responsible for the great majority of cases, and impairment was transient if therapy was discontinued. In our study, despite the therapy with TMP/SMX was immediately discontinued, and our patient underwent appropriate medical treatment, urine alkalinisation and, then, haemodialysis, the AKI was rapidly fatal. In conclusion, particular attention should be paid to prescribing TMP/SMX to patients affected by chronic renal failure.

In the literature, hypothyroidism-induced hyponatraemia is rare and probably occurs only in severe hypothyroidism characterised by myxoedema. An 82-year-old woman arrived at an emergency department with aphasia and a progressive cognitive impairment associated with walking problems during the last week. Examinations excluded neurological disease. The diagnosis showed a clinically relevant association between hyponatraemia and hypothyroidism disorder characterised by neurological symptoms. In conclusion, this could be one of the few cases, to our knowledge, of non-severe hypothyroidism-induced hyponatraemia.

Today, the attention to food security has grown with the awareness of resources’ scarcity, earth excessive exploitation, population growth and climate change, all factors that are associated with an impelling food emergency. A plethora of theoretical perspectives adopted in analysing food security issue reflects in diverse normative approaches. Some focus on the rapport between population demand and food supply, seeking to reduce the former or increase the latter in order to achieve food security. Applying the technological progress of scientific research will have its positive outcomes: production will increase, keeping prices low; the limited resources will be used more efficiently, decreasing the consumption of water, energy and land; the environment will benefit from a more sustainable production. However, scientific solutions, such as population control, that do not restore individuals’ entitlement to food will be ineffective in preventing food insecurity. Therefore, food security it is not achievable by the sole means of science. A greater quantity of food does not guarantee a more equal distribution of resources. Increasing food production without altering its uneven distribution will only augment this inequality, making who has access to food more secure but not helping who is currently affected by the food insecurity issues. Science can play its role, but development towards the solutions to food insecurity must be led by politics.

Introduction. A mass gathering (MG) is when a large number of people come together in a particular location for a specific purpose. Expo 2015 was an universal exposition hosted by Milan, Italy. The Pre-Hospital Emergency Company (AREU) of Lombardy Region (Milan-Italy) was involved in planning and managing the emergency rescue response inside the Expo 2015 area in Milan. In this paper, we review the AREU medical and public health response for the 2015 Milan Expo. Methods. Existing risk-assessment processes for MGs were used (the Arbon Predictive Score and Maurer Score) to define the expected resources and the impact on the health systems. The objective of the plan was to reduce the impact of the event by adopting the model of First Aid Points (advanced medical posts) deployed in the event site acting as ‘first health filters’ for the hospital network in Milan. Results. Our data indicate that 13,579 visitors were rescued in the ‘Red Area’ from 1 May to 31 October (with an average of 73 cases per day); 9,501 of them needed initial treatment or observation time at the First Aid Points, 1,289 of them were hospitalised (1% Red code, 29% Yellow code, 70% Green code); 65% of patients (57% female, with a mean age of 37 years old) had medical problems. Fatigue, light- headedness, dizziness, syncope, loss of consciousness and headache were the prevalent medical diagnoses. Conclusions. Our study confirms that environmental factors, such as the weather, can contribute to large numbers of ill people at MGs. Overall, the AREU of Lombardy Region demonstrated excellent preparation for the Expo 2015 MG. Flexibility, integration and strong cooperation between the pre-hospital settings and hospitals were incorporated into the application of the plan. The final data showed the effectiveness of the adopted model and the reduced impact on the hospital network.

We report the case of a 40-year-old woman presenting during the night to the emergency department for thoracic pain and pain in the upper arm. An electrocardiogram (ECG) showed diffuse ST segment elevation. A coronarography (CVG) showed spontaneous dissection of the interventricular anterior artery. Many patients present with chest pain to emergency departments (ED). Spontaneous coronary artery dissection (SCAD) should be considered in any young patient, especially young women, without a history of coronary heart disease or risk factors, who presents with an acute myocardial infarction or cardiac arrest.