Acute myocardial infarction caused by multivessel spontaneous coronary artery dissection in a postpartum woman

Spontaneous coronary artery dissection is a rare cause of acute ischemic coronary events and sudden cardiac death. It usually occurs in young women not experiencing traditional risk factors for coronary artery disease during pregnancy or postpartum period. The pathophysiology of spontaneous arterial...

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Bibliographic Details
Published inMinerva cardioangiologica Vol. 61; no. 1; p. 89
Main Authors Vecchio, S, Varani, E, Balducelli, M, Aquilina, M, Vecchi, G, Margheri, M
Format Journal Article
LanguageEnglish
Published Italy 01.02.2013
Subjects
Adult
Aneurysm, Dissecting - complications
Coronary Aneurysm - complications
Female
Humans
Myocardial Infarction - etiology
Puerperal Disorders - etiology
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Summary:Spontaneous coronary artery dissection is a rare cause of acute ischemic coronary events and sudden cardiac death. It usually occurs in young women not experiencing traditional risk factors for coronary artery disease during pregnancy or postpartum period. The pathophysiology of spontaneous arterial dissection remains uncertain and the management may be challenging. Herein, we report a case of a 41-year woman with no apparent cardiovascular risk factors, who underwent a successfull in vitro fertilization and embryo transfer with a subsequent at term cesarean section of a twin pregnancy. Six days after delivery, she presented with anterior ST-segment elevation myocardial infarction. Coronary angiography revealed dissection of all three coronary arteries with involvement of left main stem, which was successfully treated with percutaneous coronary intervention and drug-eluting stents implantation. The peculiarities of the case, toghether with the treatment strategy and the clinical and angiographic six-month follow-up are discussed.
ISSN:0026-4725