We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Spontaneous pregnancy-associated coronary artery dissection: a case report on diagnostic and therapeutic challenges.
- Authors
Haney, Ailís Ceara; Siry, Deborah; Hoerbrand, Isabel Amber-Rose; Ehlermann, Philipp; Beckendorf, Jan
- Abstract
Background One of the main causes of myocardial infarction during pregnancy is spontaneous coronary artery dissection. This is ascribed to hormonal changes during pregnancy leading to a weakening of the vessel wall and haemodynamic changes especially during childbirth. Management options include conservative medical treatment and percutaneous coronary intervention, depending on clinical presentation. Case summary A 37-year-old woman presented with typical chest pain six weeks after giving birth to her third child. Echocardiography revealed a moderate reduction in systolic function. Initial invasive coronary angiography showed no abnormalities. After cardiac magnetic resonance demonstrated extensive scar, invasive coronary angiography was repeated including intravascular imaging. A dissection of the left anterior descending artery was visualized and treated by percutaneous coronary intervention and stenting. Left ventricular function was normalized at three-month follow-up. In this educational case report, we highlight the diagnostic and therapeutic challenges when treating this special patient cohort and the importance of cardiovascular imaging. Discussion Pregnancy-associated spontaneous coronary dissection is a potential differential diagnosis when treating post-partum women with recent onset chest pain. Management is challenging and intravascular imaging to visualize dissection should be performed during invasive coronary angiography. Patients require interdisciplinary care within a pregnancy heart team.
- Subjects
SPONTANEOUS coronary artery dissection; CHEST pain; CARDIAC magnetic resonance imaging; PERCUTANEOUS coronary intervention; CORONARY angiography; SURGICAL stents
- Publication
European Heart Journal Case Reports, 2024, Vol 8, Issue 5, p1
- ISSN
2514-2119
- Publication type
Article
- DOI
10.1093/ehjcr/ytae204