Coronary artery spasm: Is ST-elevation key for diagnosis?

Area of Science:

• Cardiology
• Obstetrics
• Women's Health

Background:

• Coronary vasospasm is a rare but serious condition.
• It is particularly uncommon during pregnancy and the postpartum period.
• Prompt diagnosis and management are crucial for patient outcomes.

Observation:

• A 36-year-old woman, two weeks postpartum, experienced acute coronary vasospasm.
• Coronary arteriography revealed vasospasm in the distal left anterior descending and circumflex coronary arteries.
• Electrocardiogram (ECG) showed atypical T-wave inversions, lacking classic ST elevation.

Findings:

• This is the first documented case of postpartum coronary artery vasospasm with atypical ECG findings.
• The absence of ST elevation on ECG in this case challenges typical presentations.
• The findings underscore the diverse clinical manifestations of coronary vasospasm.

Implications:

• Clinicians should consider coronary vasospasm in postpartum women presenting with atypical cardiac symptoms.
• Early recognition and appropriate management, following standard protocols for acute coronary vasospasm, are essential.
• This case expands the understanding of coronary vasospasm during the postpartum period.