Pregnancy associated spontaneous coronary artery dissection: A case report and review of literature

Abstract

BACKGROUND Pregnancy-associated spontaneous coronary artery dissection (PSCAD) is an important cause of chest pain and acute myocardial infarction in pregnant and postpartum women. Pregnancy is considered an isolated risk factor for spontaneous coronary artery dissection. The etiology, pathogenesis, and incidence of PSCAD are not known. CASE SUMMARY We present a case of a 33-year-old postpartum female who presented with sudden onset chest pain and was diagnosed with spontaneous coronary artery dissection and needed urgent catheterization revealing left anterior descending coronary artery dissection. She underwent emergent coronary artery bypass graft surgery with good post-operative recovery. CONCLUSION Most patients with PSCAD can be managed conservatively with medical management and have good outcomes. Patients with high-risk presentations benefit from the invasive approach. Coronary artery bypass graft may be required in select few patients based on angiography findings. Due to the risk of recurrent spontaneous coronary artery dissection, subsequent pregnancies are discouraged.

Perioperative management of acute myocardial infarction in the 31st week of pregnancy: A case report and literature review

“…Spontaneous coronary artery dissection (SCAD) is a main etiology of PAMI and has been reported to occur in 15% to 40% of acute coronary syndrome (ACS) cases during pregnancy ( 2 ). To date, there are still many gaps in the understanding of PAMI, as guidelines for the management of PAMI are still limited ( 7 ). Management of puerperae suffering acute myocardial infarction could present significant clinical challenges to perinatal multidisciplinary teams ( 1 , 8 ).…”