Spontaneous Coronary Artery Dissection Post Partum

A previously healthy 30-year-old woman presented with intensive anterior myocardial infarction at day 6 post partum. Coronary angiogram demonstrated a proximal left anterior descending coronary artery dissection with an intimal flap starting at the ostial segment and extending to the mid segment separating a large false lumen from a narrow true lumen. Percutaneous coronary intervention was successfully performed using a drug-eluting stent with good angiographic result. Optical coherence tomography showed a widely patent vessel with a crescent hypointense image spanning the stent struts, suggesting a subintimal hematoma. At 1 year, the patient was asymptomatic and imaging showed patency of the stent with no residual wall hematoma.