Spontaneous Coronary Artery Dissection in a Postpartum Female: Case Report and Simplified Algorithm for its Diagnosis and Management

被引:1
作者
Agrawal, Nikhil [1 ]
Khunger, Arjun [2 ]
Dalal, Kinan [3 ]
Zahid, Usman [1 ]
Petrie, Timothy [3 ]
机构
[1] Univ Buffalo, Internal Med, Buffalo, NY 14260 USA
[2] Cleveland Clin, Oncol, Cleveland, OH 44106 USA
[3] Univ Buffalo, Cardiol, Buffalo, NY USA
关键词
spontaneous coronary artery dissection; postpartum; pregnancy; interventional cardiology; angiography; ekg; transthoracic echocardiography; pci; cabg; medical treatment; PREVALENCE; PREGNANCY; PROGNOSIS;
D O I
10.7759/cureus.4387
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Spontaneous coronary artery dissection is a rare, life-threatening cause of acute myocardial infarction that must always be considered in the differential diagnosis, particularly in young, healthy women with a paucity of typical risk factors for heart disease. We present a case of a 39-year-old White woman, three months postpartum, presenting with severe epigastric chest pain radiating to her neck. Subsequent workup using coronary angiography revealed spontaneous dissection of the distal left anterior descending artery. The patient was successfully managed by conservative treatment using low dose aspirin, metoprolol, and captopril, highlighting that hemodynamically stable patients with lesions in distal branches of coronary arteries and single-vessel disease can be successfully managed in a conservative fashion, without the need for surgical or percutaneous revascularization.
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页数:7
相关论文
共 19 条
  • [1] Spontaneous left main stem coronary artery dissection in a young postpartum woman
    Aprigliano, Gianfranco
    Palloshi, Altin
    Morici, Nuccia
    [J]. JOURNAL OF CARDIOVASCULAR MEDICINE, 2017, 18 (09) : 721 - 722
  • [2] Elming H, 1999, SCAND CARDIOVASC J, V33, P175
  • [3] Pregnancy and the Risk of Spontaneous Coronary Artery Dissection An Analysis of 120 Contemporary Cases
    Havakuk, Ofer
    Goland, Sorel
    Mehra, Anil
    Elkayam, Uri
    [J]. CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2017, 10 (03)
  • [4] Spontaneous Coronary Artery Dissection: Current State of the Science A Scientific Statement From the American Heart Association
    Hayes, Sharonne N.
    Kim, Esther S. H.
    Saw, Jacqueline
    Adlam, David
    Arslanian-Engoren, Cynthia
    Economy, Katherine E.
    Ganesh, Santhi K.
    Gulati, Rajiv
    Lindsay, Mark E.
    Mieres, Jennifer H.
    Naderi, Sahar
    Shah, Svati
    Thaler, David E.
    Tweet, Marysia S.
    Wood, Malissa J.
    [J]. CIRCULATION, 2018, 137 (19) : E523 - E557
  • [5] Spontaneous Coronary Artery Dissection (SCAD): New Insights into This Not-So-Rare Condition
    Hayes, Sharonne N.
    [J]. TEXAS HEART INSTITUTE JOURNAL, 2014, 41 (03) : 295 - 298
  • [6] Spontaneous Peripartum Coronary Artery Dissection Presentation and Outcome
    Higgins, George L., III
    Borofsky, Jennifer S.
    Irish, Christine B.
    Cochran, Thomas S.
    Strout, Tania D.
    [J]. JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE, 2013, 26 (01) : 82 - 89
  • [7] Koul AK, 2001, CATHETER CARDIO INTE, V52, P88, DOI 10.1002/1522-726X(200101)52:1<88::AID-CCD1022>3.0.CO
  • [8] 2-P
  • [9] Maeder M, 2005, Z KARDIOL, V94, P829, DOI 10.1007/s00392-005-0302-6
  • [10] Spontaneous Coronary Artery Dissection: A Western Denmark Heart Registry Study
    Mortensen, K. H.
    Thuesen, L.
    Kristensen, I. B.
    Christiansen, E. H.
    [J]. CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2009, 74 (05) : 710 - 717