Spontaneous Coronary Artery Dissection in a Lactating Mother Three Years Postpartum: A Rare Case Report

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS), typically seen in young women during or shortly after pregnancy. SCAD occurring beyond one year postpartum is uncommon, and no clear association has been established with prolonged lactation. We present the case of a 41-year-old woman, actively breastfeeding her three-year-old child, with no traditional cardiovascular risk factors. She presented with ST-elevation myocardial infarction (STEMI). Coronary angiography revealed a sudden change in the calibre of the distal left anterior descending artery (LAD), followed by a long segment of narrowing and eventual subtotal occlusion. The clinical picture and angiographic findings were consistent with SCAD. She was managed conservatively and is undergoing further evaluation for fibromuscular dysplasia and other arteriopathies. This case represents a rare, delayed postpartum presentation of SCAD in the context of prolonged lactation, with angiographic features of coronary tortuosity and subtotal occlusion of the distal LAD. It highlights the need to consider SCAD even years after childbirth and in patients with non-traditional risk factors.