Preeclampsia-Associated Multivessel Spontaneous Coronary Artery Dissection

Area of Science:

• Cardiology
• Obstetrics
• Vascular Biology

Background:

• Pregnancy-associated spontaneous coronary artery dissection (PASCAD) is an uncommon yet severe complication, representing less than 5% of all spontaneous coronary artery dissection (SCAD) cases.
• PASCAD is often characterized by a more aggressive clinical presentation compared to non-pregnancy-related SCAD.
• Identified risk factors for PASCAD include Black ethnicity, multiparity, hypertension, advanced maternal age, and older age at first childbirth.

Observation:

• This report presents an atypical case of PASCAD in a preeclamptic patient.
• The patient presented with an ST-segment elevation myocardial infarction (STEMI).

Findings:

• Multivessel dissection involving both the left anterior descending (LAD) and right coronary arteries were identified as co-culprit lesions.
• The dissection led to acute myocardial infarction in the context of preeclampsia.

Implications:

• This case underscores the importance of considering PASCAD in pregnant or postpartum women presenting with acute coronary syndromes.
• Early recognition and management of PASCAD are crucial due to its aggressive nature.
• Further research into the pathophysiology and optimal management strategies for PASCAD is warranted.