Physicians must maintain a high index of suspicion for spontaneous coronary artery dissection when young, healthy postpartum women present with symptoms of acute coronary syndrome.
Spontaneous coronary artery dissection (SCAD) is a rare but life-threatening cause of acute coronary artery syndrome. Although, SCAD may be attributed to underlying medical illness such as connective tissue disease, vasculitis or atherosclerosis, its occurrence in young healthy females is an uncommon phenomenon. Pregnant females, particularly in their peripartum or post-partum periods are affected the most. The etiology remains unclear but certain factors such as hemodynamic and hormonal changes during pregnancy have thought to play a significant role. Spontaneous coronary artery dissection has a very high mortality rate and physicians should be vigilant when an otherwise young healthy female presents with symptoms of acute coronary syndrome.
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Mehta et al. (2019) studied this question.
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