Spontaneous coronary artery dissection in puerperium
Medhat Refaie1, Mohammed Alshehri2, Ricardo Gallo2
1Department of Cardiac Surgery, King Fahad Hospital Southern Region, Khamis Mushayt, Saudi Arabia refaiemedhat@yahoo.com.
Asian Cardiovascular & Thoracic Annals
|March 10, 2015
Summary
Spontaneous coronary artery dissection (SCAD) during puerperium is rare, typically occurring in late pregnancy or early postpartum. This case highlights a 41-year-old woman experiencing SCAD two weeks after delivery, requiring urgent surgical intervention.
Area of Science:
- Cardiology
- Obstetrics
- Vascular Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of myocardial infarction, particularly in the puerperium.
- SCAD incidence peaks during the third trimester and early postpartum period.
Observation:
- A 41-year-old woman presented with chest pain and ECG changes two weeks postpartum.
- Elevated troponin I levels indicated myocardial injury.
- Coronary angiography revealed left main coronary artery dissection extending to the LAD and diagonal branch.
Findings:
- The patient underwent successful urgent coronary artery bypass grafting.
- The dissection involved critical coronary arteries, necessitating immediate surgical management.
Implications:
- This case underscores the importance of considering SCAD in postpartum women presenting with acute coronary syndromes.
- Timely diagnosis and surgical revascularization are crucial for favorable outcomes in SCAD during puerperium.
Related Concept Videos
01:30Peripheral Artery Disease I: Introduction
646
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
646
01:26Coronary Artery Disease II: Pathophysiology
1.0K
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
1.0K
01:30Coronary Artery Disease I: Introduction
1.7K
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
1.7K
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
803
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
803
01:30Acute Coronary Syndrome I: Introduction
1.8K
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.8K