Postpartum Spontaneous Coronary Artery Dissection Involving the Left Main Coronary Artery: A Case Report

Postpartum spontaneous coronary artery dissection (PSCAD) is a non-iatrogenic coronary artery wall separation typically occurring within weeks of childbirth and resulting in vessel occlusion and heart attack. This report presents a case of PSCAD involving the left main (LM) coronary artery.

A 27-year-old woman was admitted to emergency care due to sudden chest pain lasting for 1.5 hours. Coronary angiography suggested complete occlusion of the LM coronary artery, and she was urgently transferred to a provincial-level hospital. A 3.0 ×22-mm Endeavor Resolute stent was implanted in the proximal LM and left anterior descending coronary arteries. Postoperatively, mechanical circulatory support was provided using veno-arterial extracorporeal membrane oxygenation (VA-ECMO), an intra-aortic balloon pump (IABP), intermittent continuous renal replacement therapy, and non-invasive ventilation. The clinical symptoms of the patient improved temporarily. However, after withdrawal of the IABP and VA-ECMO, the patient's symptoms worsened, and she died while awaiting heart transplantation.

We report a rare case of PSCAD involving the LM coronary artery with the aim of enhancing clinicians' understanding of PSCAD and providing insights for treatment approaches.