Apical hypertrophic cardiomyopathy with spontaneous post partum coronary artery dissection

Primary coronary dissection is usually a catastrophic event with a fatal outcome; less than 20 cases of long term survival have been reported. A 32-year-old woman with apical hypertrophic cardiomyopathy who survived a spontaneous dissection of the left anterior descending coronary artery and acute anterior wall infarction two days postpartum is described. To the authors' knowledge, the simultaneous occurrence of these two rare conditions has never been previously reported. Thallium-dipyridamole imaging was performed to estimate the amount of residual viable myocardium in the infarcted area and to evaluate the hemodynamic significance of the residual luminal narrowing. Myocardial perfusion imaging can be useful to decide on surgical versus conservative treatment of these patients.