Spontaneous aortic dissection can occur in third-trimester pregnancy even without traditional risk factors, requiring high clinical suspicion and rapid intervention.
Case underscores need for aortic dissection suspicion in third-trimester chest pain; leaves open optimal screening and rapid diagnostics in low-risk pregnancies.
Spontaneous aortic dissection in pregnancy is rare and life threatening for both the mother and the fetus. Most commonly, it is associated with connective tissue disorders, cardiac valve variants, or trauma. We present the case of a 23-year-old previously healthy woman, 36 weeks pregnant with a syncopal episode after dyspnea and vomiting. She subsequently developed cardiac arrest and underwent aggressive resuscitation, emergent thoracotomy, and cesarean delivery without recovery. On autopsy, she was found to have an aortic dissection of the ascending aorta. This case is presented to raise awareness and review the literature and the clinical approach to critical care for pregnant patients.
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Kinney-Ham et al. (2011) studied this question.
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