Postpartum Coronary Arterial Spasm

Area of Science:

• Cardiology
• Obstetrics
• Emergency Medicine

Background:

• Acute coronary syndrome (ACS) is uncommon during the postpartum period.
• This case presents a rare instance of ACS in a postpartum patient without typical risk factors like smoking or medication use.

Observation:

• A 26-year-old woman presented with sudden chest pain and ST-segment elevation on day five postpartum.
• Coronary angiography revealed multifocal coronary artery spasm.

Findings:

• Intracoronary administration of nitroglycerin and verapamil effectively relieved the coronary vasospasm.
• The patient recovered uneventfully and was discharged in stable condition.

Implications:

• Coronary vasospasm should be considered in the differential diagnosis of peripartum chest pain.
• Prompt diagnosis and treatment of peripartum ACS are critical.
• Nitrates, potentially with calcium channel blockers, are key for managing vasospastic coronary disease recurrence and prevention.