Coronary Artery Dissection: A Spontaneous Phenomena in Postpartum Period

Sanwal Sing Mehta¹, Muhammad Usman Asghar^2, , Hira Cheema³ and Krishna Kommineni¹

¹Internal Medicine, Maimonides Medical Center, New York, USA

²Surgery, New York University School of Medicine, New York, USA

³Internal Medicine, Shifa College of Medicine, Islamabad, Pakistan

Cite this paper

Sanwal Sing Mehta, Muhammad Usman Asghar, Hira Cheema and Krishna Kommineni. Coronary Artery Dissection: A Spontaneous Phenomena in Postpartum Period. American Journal of Medical Case Reports. 2019; 7(7):133-134. doi: 10.12691/AJMCR-7-7-3

Abstract

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.

Keywords

coronary artery dissection, pregnancy, postpartum

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Dhavan R, Singh G, Fesniak H. Spontaneous coronary artery dissection: The clinical spectrum. Angiology 2002; 53: 89-92.
[2]	Kamineni R, Sadhu A, Alpert JS. Spontaneous coronary artery dissection: Report of two cases and 50-year review of the literature. Cardiol Rev 2002; 10: 279-84.
[3]	Sharma AD, Sreeram G, Slaughter TF. Spontaneous coronary artery dissection in healthy 24-year-old woman. J Cardiothor Vasc Anesthesia 2000; 14: 312-13.
[4]	DeMaio SJ, Kinsella SH, Silverman ME. Clinical course and long-term Prognosis of spontaneous coronary artery dissection. Am J Cardiol 1989; 64: 471-74.
[5]	Koul AK, Hollander G, Moscovits N, et al. Coronary artery dissection during pregnancy and the postpartum period: Two case reports and review of literature. Cathet Cardiovasc Intervent 2001; 52: 88-94.
[6]	Mohamed HA, Eshawesh A, Habib N. Spontaneous coronary artery dissection. A case report and review of the literature. Angiology 2002; 53: 205-11.
[7]	Samuels LE, Kaufman MS, Morris RJ, Br, et al. Postpartum coronary artery dissection: Emergency coronary artery bypass with ventricular assist device support. Coron Art Dis 1998; 9: 457-60.
[8]	Virmani R, Forman MB, Rabinowitz M, et al. Coronary artery dissections. Cardiol Clinics 1984; 2: 633-45.
[9]	Asuncion CM, Hyun J. Dissecting intramural hematoma of the coronary artery in pregnancy and the puerperium. Obstet Gynecol 1972; 40: 202-10.
[10]	Bonnet J, Aumailley M, Thomas D, et al. Spontaneous coronary artery dissection: case report and evidence for a defect in collagen metabolism. Eur Heart J 1986; 7: 904-09.
[11]	Roth A, Elkayam U. Acute myocardial infarction associated with pregnancy. Ann Intern Med 1996; 125: 751-62.
[12]	Borczuk AC, van Hoeven KH, Factor SM. Review and hypothesis: the eosinophil and peripartum heart disease (myocarditis and coronary artery dissection) – coincidence or pathogenetic significance?. Cardiovasc Res 1997; 33: 527-32.
[13]	Hanratty CG, McKeown PP, O'Keeffe BD. Coronary stenting in the setting of spontaneous coronary artery dissection. Internatl J Cardiol 1998; 67: 197-99.