Spontaneous Coronary Artery Dissection Presenting As ST-Segment Elevation Myocardial Infarction.
Israa Taha1, Timothy Daly1, Kashyap Shah1
1Internal Medicine, St. Luke's University Health Network, Bethlehem, USA.
Cureus
|June 13, 2022
Summary
Spontaneous coronary artery dissection (SCAD) is a leading cause of heart attack in pregnant women. This case highlights a 36-week pregnant woman who suffered a heart attack due to SCAD in her main coronary artery.
Area of Science:
- Cardiology
- Obstetrics
- Vascular Biology
Background:
- Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute myocardial infarction (AMI), particularly in young to middle-aged women.
- Pregnancy is a significant risk factor for AMI, with SCAD accounting for the majority of these events in pregnant individuals.
- The physiological changes during pregnancy, including hormonal shifts and increased cardiac workload, may predispose to arterial wall stress and dissection.
Observation:
- A 36-year-old female at 36-weeks gestation presented with an ST-segment elevation myocardial infarction (STEMI).
- The patient experienced ventricular fibrillation arrest, indicating a severe ischemic event.
- Coronary angiography revealed spontaneous dissection of the left anterior descending (LAD) coronary artery as the underlying cause.
Findings:
- The case demonstrates a rare but critical presentation of SCAD in late-stage pregnancy.
- SCAD led to STEMI and subsequent life-threatening ventricular arrhythmia in a pregnant patient.
- The dissection involved the left anterior descending artery, a major coronary vessel.
Implications:
- This case underscores the importance of considering SCAD in pregnant women presenting with acute coronary syndromes.
- Prompt diagnosis and management of SCAD in pregnancy are crucial to improve maternal and fetal outcomes.
- Further research is needed to elucidate the specific mechanisms linking pregnancy and SCAD to optimize prevention and treatment strategies.
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