Repeat Coronary Artery Dissection in Pregnancy: A Case Report and Review of the Literature

Non‐atherosclerotic spontaneous coronary artery dissection (NA‐SCAD) is a rare cause of morbidity and mortality with a propensity for young, healthy, and often peripartum women. NA‐SCAD etiology is poorly understood, with possible hormonal and hereditary mechanisms. Current treatment strategies rang...

Full description

Saved in:
Bibliographic Details
Published inJournal of forensic sciences Vol. 62; no. 5; pp. 1389 - 1394
Main Authors Bitting, Casey P., Zumwalt, Ross E.
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.09.2017
Subjects
acute coronary syndrome
Adult
Atherosclerosis
Autopsies
Case reports
Coronary Thrombosis - pathology
Coronary Vessel Anomalies - pathology
Coronary vessels
Dissection
Etiology
Fatal Outcome
Female
Forensic pathology
forensic science
Humans
Literature reviews
multiple
Myocardial infarction
Myocardial Infarction - pathology
peripartum
Pregnancy
Puerperal Disorders - pathology
recurrent
spontaneous coronary artery dissection
Vascular Diseases - congenital
Vascular Diseases - pathology
acute coronary syndrome
forensic pathology
spontaneous coronary artery dissection
myocardial infarction
peripartum
pregnancy
forensic science
multiple
female
recurrent
Online AccessGet full text

Cover

More Information
Summary:Non‐atherosclerotic spontaneous coronary artery dissection (NA‐SCAD) is a rare cause of morbidity and mortality with a propensity for young, healthy, and often peripartum women. NA‐SCAD etiology is poorly understood, with possible hormonal and hereditary mechanisms. Current treatment strategies range from conservative management (often showing resolution on angiographic follow‐up) to invasive angiographic procedures. Rarely, NA‐SCAD has recurred in another coronary artery, ranging hours to years later. We report NA‐SCAD of the right coronary artery (RCA) in a 30‐year old, 3‐month postpartum female with an additional autopsy finding of remote myocardial infarction (MI) in the left anterior descending (LAD) coronary artery territory. The remote MI is consistent with prior NA‐SCAD of the LAD and, given the medical history, may have occurred in the peripartum period of the decedent first pregnancy 3 years earlier. As such, to the best of our knowledge, this may represent the first reported case of NA‐SCAD recurrence in a subsequent pregnancy.
Bibliography:ObjectType-Case Study-3
SourceType-Scholarly Journals-1
content type line 23
ObjectType-Review-1
ObjectType-Feature-5
ObjectType-Report-2
ObjectType-Article-4
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.13436