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Acute Aortic Dissection in Third Trimester Pregnancy without Risk Factors
Lisa Kinney-Ham1, H Bryant Nguyen, Robert Steele
1Loma Linda University, Department of Emergency Medicine, Loma Linda, California.
The Western Journal of Emergency Medicine
|January 7, 2012
Summary
Spontaneous aortic dissection during pregnancy is a rare, life-threatening event. This case highlights the critical need for prompt recognition and management in pregnant patients facing cardiovascular emergencies.
Area of Science:
- Cardiovascular Medicine
- Obstetrics and Gynecology
- Critical Care Medicine
Background:
- Spontaneous aortic dissection (SAD) in pregnancy is a rare but catastrophic complication.
- It poses significant risks to both maternal and fetal well-being.
- Associated factors include connective tissue disorders, cardiac valve abnormalities, and trauma.
Purpose of the Study:
- To present a case of spontaneous aortic dissection in a previously healthy pregnant woman.
- To raise awareness of this rare condition in obstetrics.
- To review the literature and discuss critical care management strategies for pregnant patients with aortic dissection.
Main Methods:
- Case report of a 23-year-old woman at 36 weeks gestation presenting with syncopal episode, dyspnea, and vomiting.
- Inclusion of autopsy findings revealing ascending aorta dissection.
- Review of existing literature on spontaneous aortic dissection in pregnancy and critical care approaches.
Main Results:
- The patient experienced cardiac arrest and underwent emergent thoracotomy and cesarean delivery without successful resuscitation.
- Autopsy confirmed dissection of the ascending aorta.
- The case underscores the rapid deterioration possible in this condition.
Conclusions:
- Spontaneous aortic dissection in pregnancy requires heightened clinical suspicion.
- Multidisciplinary critical care and timely intervention are crucial.
- Further research into optimal management protocols is warranted.
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