Why the study?
Pregnancy-associated spontaneous coronary artery dissection is an important cause of chest pain and acute myocardial infarction in pregnant and postpartum women, but its etiology, pathogenesis, and incidence are not known.
Pregnancy-associated spontaneous coronary artery dissection can present with sudden chest pain requiring urgent catheterization, and while most cases are managed conservatively, high-risk presentations may require CABG.
BACKGROUND: Pregnancy-associated spontaneous coronary artery dissection (PSCAD) is an important cause of chest pain and acute myocardial infarction in pregnant and postpartum women. Pregnancy is considered an isolated risk factor for spontaneous coronary artery dissection. The etiology, pathogenesis, and incidence of PSCAD are not known. CASE SUMMARY: We present a case of a 33-year-old postpartum female who presented with sudden onset chest pain and was diagnosed with spontaneous coronary artery dissection and needed urgent catheterization revealing left anterior descending coronary artery dissection. She underwent emergent coronary artery bypass graft surgery with good post-operative recovery. CONCLUSION: Most patients with PSCAD can be managed conservatively with medical management and have good outcomes. Patients with high-risk presentations benefit from the invasive approach. Coronary artery bypass graft may be required in select few patients based on angiography findings. Due to the risk of recurrent spontaneous coronary artery dissection, subsequent pregnancies are discouraged.
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Prudhvi et al. (2021) studied this question.
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