Coronary artery dissection during pregnancy

Esinler, İbrahim; Yigit, Nuray; Ayhan, Ali; Kes, Sırrı; Aytemir, Kudret; Açıl, Tayfun

doi:10.1034/j.1600-0412.2003.00015.x

Cited by 11 publications

(3 citation statements)

References 20 publications

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“…28 However, angiography, catheterisation and other invasive therapies should be performed with great caution, as any force applied to the extremely fragile coronary arteries of pregnant women may lead to an extension of the dissection. 29,30 The use of thrombolytic agents in pregnancy is best avoided in patients in whom dissection is suspected.…”

Section: 22mentioning

confidence: 99%

Maternal mortality attributable to vascular dissection and rupture in the Netherlands: a nationwide confidential enquiry

Chapelle¹,

Schutte

Schuitemaker

et al. 2011

BJOG

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Objective To determine the incidence of maternal deaths attributable to vascular dissection and rupture in the Netherlands, and to assess clinical features, risk factors and the frequency of substandard care in the cases identified.Design Confidential enquiry into the causes of maternal deaths.Setting Nationwide in the Netherlands. Results A total of 23 maternal deaths attributable to vascular dissection and rupture were reported. In most cases the location was aortic (n = 13), followed by coronary (n = 4) and splenic (n = 3) arteries. Clinical features were various, but most women presented with sudden unexplainable pain. Risk factors were present in 14 cases (61%), with hypertension being most frequently reported in ten cases (43%). Substandard care was determined to have been received in 13 cases (56%), inadequate assessment of complaints and a delay in diagnosis being the most frequent problems identified.Conclusions Vascular dissection and rupture in pregnancy, although rare, carry a high risk of maternal and fetal morbidity and mortality. Because of the rarity of this condition and its variety in presentation, diagnosis is easily missed. A high index of suspicion when a woman presents with suggestive complaints, leading to an early diagnosis, may improve the prognosis for the woman and her child.Keywords Aneurysm, aortic dissection, carotid artery dissection, coronary dissection, hepatic artery dissection, iliac artery dissection, maternal mortality, pregnancy-related, splenic artery dissection, substandard care, vascular dissection, vascular rupture.Please cite this paper as: la Chapelle C, Schutte J, Schuitemaker N, Steegers E, van Roosmalen J on behalf of the Dutch Maternal Mortality Commitee. Maternal mortality attributable to vascular dissection and rupture in the Netherlands: a nationwide confidential enquiry. BJOG 2012;119:86-93.

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Section: 22mentioning

confidence: 99%

Maternal mortality attributable to vascular dissection and rupture in the Netherlands: a nationwide confidential enquiry

Chapelle¹,

Schutte

Schuitemaker

et al. 2011

BJOG

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“…10 The LAD artery is the most common site for dissection. 5,11 The etiology of SCAD is multifactorial, and pathogenesis involves a weakening of the arterial wall. Peripartum women may be at increased risk due to hormonal changes in pregnancy which affect smooth muscle cell proliferation, abnormalities in the proteoglycan matrix and reduced collagen synthesis.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous coronary artery dissection in a parturient with Nail–Patella syndrome

Nizamuddin

Broderick

Minehart

et al. 2015

International Journal of Obstetric Anesthesia

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“…Esinler [3] reported a case that found an association between them. In our case, treatment with a moderate dose of ritodrine hydrochloride was initiated 2 days before the AMI occurred.…”

Section: Discussionmentioning

confidence: 99%

What enabled mother and twins to survive 18 minutes after maternal cardiopulmonary arrest?

Matsuoka

Tanaka

Dohi

et al. 2014

Case Reports in Perinatal Medicine

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A woman carrying monochorionic twins underwent sudden cardiopulmonary arrest at 31 weeks of gestation due to spontaneous coronary artery dissection in the hospital. The resuscitation techniques, with her uterus manually displaced to her left, were initiated immediately and maternal spontaneous circulation was resumed 18 min later. A cesarean section was performed 2 h after the revival and the patient was kept hypothermic for 24 h. Finally, full recovery of both mother and twins was achieved. As in this case, the resuscitation techniques for pregnant women recommended by the American Heart Association, and therapeutic hypothermia, might be effective and contribute much to the survival and recovery of patients.

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Coronary artery dissection during pregnancy

Cited by 11 publications

References 20 publications

Maternal mortality attributable to vascular dissection and rupture in the Netherlands: a nationwide confidential enquiry

Maternal mortality attributable to vascular dissection and rupture in the Netherlands: a nationwide confidential enquiry

Spontaneous coronary artery dissection in a parturient with Nail–Patella syndrome

What enabled mother and twins to survive 18 minutes after maternal cardiopulmonary arrest?

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