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Spontaneous pregnancy-associated coronary artery dissection: a case report on diagnostic and therapeutic challenges.
- Source :
- European Heart Journal Case Reports; May2024, Vol. 8 Issue 5, p1-6, 6p
- Publication Year :
- 2024
-
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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 25142119
- Volume :
- 8
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- European Heart Journal Case Reports
- Publication Type :
- Academic Journal
- Accession number :
- 177748658
- Full Text :
- https://doi.org/10.1093/ehjcr/ytae204