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Case Reports
. 2018 Aug;8(4):512-515.
doi: 10.21037/cdt.2018.06.02.

Very early antepartum pregnancy-associated spontaneous coronary artery dissection case report

Carolyn Lee  1 , Jacqueline Saw  1
Affiliations
Case Reports

Very early antepartum pregnancy-associated spontaneous coronary artery dissection case report

Carolyn Lee et al. Cardiovasc Diagn Ther. 2018 Aug.

Abstract

Spontaneous coronary artery dissection (SCAD) is an elusive cardiovascular disease that is increasingly recognized. Classically, pregnancy had been perceived as a notable risk factor for SCAD. However, modern studies had revealed that pregnancy-associated SCAD (PASCAD) accounted for fewer cases than previously thought. The majority of PASCAD cases occur in women post-partum. We describe a case of a 30-year-old woman who presented with SCAD while 10 days pregnant, which is the earliest PASCAD case reported in the literature.

Keywords: Spontaneous coronary artery dissection (SCAD); myocardial infarction (MI); women.

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Conflict of interest statement

Conflicts of Interest: Dr. Saw has received unrestricted research grant supports (from the Canadian Institutes of Health Research, Heart & Stroke Foundation of Canada, National Institutes of Health, University of British Columbia Division of Cardiology, AstraZeneca, Abbott Vascular, St Jude Medical, Boston Scientific, and Servier), speaker honoraria (AstraZeneca, St Jude Medical, Boston Scientific, and Sunovion), consultancy and advisory board honoraria (AstraZeneca, St Jude Medical, and Abbott Vascular), and proctorship honoraria (St Jude Medical and Boston Scientific). Dr. Lee has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Coronary angiogram showing SCAD involving LA artery. (A) Baseline coronary angiography showing occluded proximal LAD (arrow); (B) coronary angiography after stent placement (arrow) in the proximal LAD; (C) coronary angiography showing diffuse narrowing of the distal LAD (starting from arrow) due to arterial compression from intramural hematoma. LAD, left anterior descending; SCAD, spontaneous coronary artery dissection.
Figure 2
Figure 2
Coronary angiogram showing occluded proximal left anterior descending artery from SCAD (3). SCAD, spontaneous coronary artery dissection. Available online: http://www.asvide.com/article/view/26382
Figure 3
Figure 3
Left ventricular angiogram during (A) diastole and (B) systole.
Figure 4
Figure 4
Coronary angiogram showing the left anterior descending artery after stenting the proximal segment, with residual diffuse narrowing distally (4). Available online: http://www.asvide.com/article/view/26384
See this image and copyright information in PMC

References

    1. Saw J, Mancini GBJ, Humphries KH. Contemporary Review on Spontaneous Coronary Artery Dissection. J Am Coll Cardiol 2016;68:297-312. 10.1016/j.jacc.2016.05.034 - DOI - PubMed
    1. Luong C, Starovoytov A, Heydari M, et al. Clinical presentation of patients with spontaneous coronary artery dissection. Catheter Cardiovasc Interv 2017;89:1149-54. 10.1002/ccd.26977 - DOI - PubMed
    1. Lee C, Saw J. Coronary angiogram showing occluded proximal left anterior descending artery from SCAD. Asvide 2018;5:677. Available online: http://www.asvide.com/article/view/26382
    1. Lee C, Saw J. Coronary angiogram showing the left anterior descending artery after stenting the proximal segment, with residual diffuse narrowing distally. Asvide 2018;5:678. Available online: http://www.asvide.com/article/view/26384
    1. Faden MS, Bottega N, Benjamin A, et al. A nationwide evaluation of spontaneous coronary artery dissection in pregnancy and the puerperium. Heart 2016;102:1974-9. 10.1136/heartjnl-2016-309403 - DOI - PubMed

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