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Type A Aortic Dissection in a Previously Healthy Pregnant Patient: A Challenging Dilemma, Case Report, and Literature
Elham Bateni1, Maryam Dehghan1, Zeinab Ahmadikia2
1Obstetrics and Gynecology Department, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Pregnancy-related aortic dissection (AoD) is a rare, fatal condition. Vigilance for new cardiopulmonary symptoms in pregnant women is crucial for timely diagnosis and intervention, saving both mother and fetus.
Area of Science:
- Cardiovascular Medicine
- Obstetrics and Gynecology
- Vascular Surgery
Background:
- Aortic dissection (AoD) is a life-threatening condition involving a tear in the aorta's inner lining, leading to a false lumen.
- Classifications include DeBakey (Types I-III) and Stanford (Types A and B).
- Pregnancy increases AoD risk in women with factors like hypertension, smoking, bicuspid aortic valve, and connective tissue disorders.
Abstract:
Aortic dissection (AoD) is a rare fatal condition in which tearing in the intima causes a false channel in the aorta and can lead to rupture. AoD is classified as the DeBakey classification (Types I, II, III) and Stanford classification (Types A and B). Women with underlying risk factors such as hypertension, smoking, bicuspid aortic valve, and connective tissue disorders are at risk for pregnancy-related AoD. These risk factors may not be recognized until the AoD occurs during pregnancy. We describe an acute incidence of type A AoD in the second trimester of pregnancy. A multiparous woman with no previously known risk factor presented with nonspecific chest pain. She was found to have AoD and underwent successful surgical intervention. This case demonstrates the importance of vigilance in the evaluation of pregnant women with new cardiopulmonary symptoms. A multidisciplinary approach can save the mother and the fetus.
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