Spontaneous left coronary artery dissection in the postpartum period: a case report

Кузнецов, А. А.; Намитоков, А. М.; Sazhneva, A. V.; Nekrasov, A. S.; Космачева, Е. Д.

doi:10.15829/1560-4071-2022-5059

Russ J Cardiol

2022

DOI: 10.15829/1560-4071-2022-5059

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Spontaneous left coronary artery dissection in the postpartum period: a case report

А. А. Кузнецов

А. М. Намитоков

A. V. Sazhneva³

et al.

Abstract: Spontaneous coronary artery dissection is a rare disease that threatens the patient life. Often this pathology complicates the course of pregnancy or the postpartum period. The rare occurrence and difficulties in diagnosis are the reason for the lack of data and the impossibility of developing a single algorithm for diagnosing and treating spontaneous coronary artery dissection.The article provides a brief literature review and a case report of spontaneous coronary artery dissection in the postpartum period, a… Show more

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Cited by 2 publications

References 11 publications

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Clinical features of acute coronary syndrome associated with spontaneous coronary artery dissection in women: a case series

Nedbaeva,

Aseeva,

Zhiduleva

et al. 2024

Russ J Cardiol

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Spontaneous coronary artery dissection (SCAD) is defined as a spontaneous dissection of the coronary artery wall that occurs independently of atherosclerosis, percutaneous coronary intervention, or mechanical trauma. Its distinctive feature is high prevalence in young women. This condition is associated with pregnancy and hormonal changes. A number of risk factors have been identified, including vascular pathology (most commonly fibromuscular dysplasia), other hereditary connective tissue disorders, systemic inflammatory diseases, migraine, and thyroid diseases. Nevertheless, the precise mechanisms of the pathophysiological relationship remain to be elucidated, and risk factors cannot be identified in all patients, indicating the complex and incompletely understood nature of the disease. The present article presents a case series on the development of SCAD in women and a review of the predisposing factors for the disease.

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Clinical features of acute coronary syndrome associated with spontaneous coronary artery dissection in women: a case series

Nedbaeva,

Aseeva,

Zhiduleva

et al. 2024

Russ J Cardiol

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Spontaneous anterior coronary interventricular artery dissection in a young woman in the late postpartum period: clinical case

Anokhina,

Matyushin,

Ustyugov

et al. 2023

CardioSomatics

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BACKGROUND: Cardiovascular complications during pregnancy and postpartum period are rare but often fatal. The causes and mechanisms of the development of such complications are not fully understood. Spontaneous dissection of the coronary artery against the background of the influence of sex hormones is one of the mechanisms for the development of acute coronary syndrome in the postpartum period. The false lumen of the intramural hematoma overlaps the true lumen, causing arterial obstruction, leading to acute myocardial hypoxia. Thus, awareness that the pathophysiology of spontaneous coronary artery dissection differs from that of acute coronary syndrome associated with atherosclerotic plaque rupture is important, and these patients require different treatment approaches. Currently, an unambiguous and precise strategy for this pathology has not been established, which is why difficulties remain in the management of these patients and choosing treatment strategies. CLINICAL CASE DESCRIPTION: The article describes a complex clinical case of the development of acute myocardial infarction in the postpartum period in a young woman without risk factors against the background of spontaneous dissection of the coronary artery, complicated by cardiogenic shock, which required emergency percutaneous coronary intervention and stenting of the infarct-dependent artery. The postoperative period proceeded with complications, and extracorporeal membrane oxygenation was required. However, an integrated approach and correctly chosen treatment strategies help stabilize the patients condition. CONCLUSION: Currently, no unambiguous and precise strategy of treatment has been established, so difficulties remain in the management of patients and decision making. In our opinion, an individual patient approach should be followed, taking into account the general state of the organism, type and volume of dissection, consequences and complications, and experience and technical capabilities of the clinic.

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Spontaneous left coronary artery dissection in the postpartum period: a case report

Cited by 2 publications

References 11 publications

Clinical features of acute coronary syndrome associated with spontaneous coronary artery dissection in women: a case series

Clinical features of acute coronary syndrome associated with spontaneous coronary artery dissection in women: a case series

Spontaneous anterior coronary interventricular artery dissection in a young woman in the late postpartum period: clinical case

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