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Case Reports
. 2024 Aug 1;16(8):e65968.
doi: 10.7759/cureus.65968. eCollection 2024 Aug.

Spontaneous Coronary Artery Dissection in the Late Third Trimester of Pregnancy

Nikolaos Antonakopoulos  1 , Figalia Nika  1 , Panagiota Tzela  2 , Alexandros Tousis  3 , Leonidas Antonakis  1 , Periklis Davlouros  3 , Georgios Adonakis  1
Affiliations
Case Reports

Spontaneous Coronary Artery Dissection in the Late Third Trimester of Pregnancy

Nikolaos Antonakopoulos et al. Cureus. .

Abstract

Acute coronary syndrome due to a non-atherosclerotic, non-traumatic, or iatrogenic-induced spontaneous coronary artery dissection (SCAD) is a rare clinical condition that affects mostly young women of reproductive age. In this case, we present a 36-week-pregnant, 35-year-old G2P1 woman, with no previous medical history, who was admitted to our hospital with premature pre-labor contractions. During her hospitalization, she underwent a coronary artery percutaneous angiography revealing SCAD of the three coronary vessels, after an episode of acute-onset chest pain, tachypnea, EKG alterations, cardiac enzyme elevation, and bilateral pleural effusions. An emergency cesarean delivery was performed and the patient was transferred to the cardiology intensive care unit. Conservative management was decided and the woman was discharged a few days later.

Keywords: acute-onset chest pain; bilateral pleural effusions; myocardial infarction; pathophysiological changes in pregnancy; percutaneous angiography; pregnancy; scad; spontaneous coronary artery dissection; tachypnea.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. ECG showed sinus rhythm with no tachycardia and no ST abnormalities.
Figure 2
Figure 2. Computed tomography pulmonary angiography (axial view) showing significant pleural effusions (black arrows) bilaterally.
Figure 3
Figure 3. Coronary artery angiography confirmed the diagnosis of spontaneous coronary artery dissection.
Arrows indicate the site of arterial wall dissection.
See this image and copyright information in PMC

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