Pregnancy-Associated Spontaneous Coronary Dissection in a 32-Year-Old During the Third Trimester

Q4 Medicine

JACC. Case reports Pub Date : 2025-01-15 DOI:10.1016/j.jaccas.2024.102769

Nikolaos Tsianakas MD , Frank Oehmke MD , Vera Müller MD , Jakob Lorenz MD , Holger Nef MD , Christian Hamm MD , Samuel Sossalla MD , Michael Sander MD , Ivo Meinhold-Heerlein MD , Oliver Dörr MD

{"title":"Pregnancy-Associated Spontaneous Coronary Dissection in a 32-Year-Old During the Third Trimester","authors":"Nikolaos Tsianakas MD , Frank Oehmke MD , Vera Müller MD , Jakob Lorenz MD , Holger Nef MD , Christian Hamm MD , Samuel Sossalla MD , Michael Sander MD , Ivo Meinhold-Heerlein MD , Oliver Dörr MD","doi":"10.1016/j.jaccas.2024.102769","DOIUrl":null,"url":null,"abstract":"<div><div>We report a case of spontaneous coronary dissection (SCAD) in a 32-year-old pregnant patient during the seventh month of her second pregnancy. A 32-year-old pregnant woman in the 28th week of gestation was referred to our intensive care unit because of angina as well as elevated troponin levels. The initial electrocardiogram and transthoracic echocardiogram (TTE) were normal. Four hours after admission, the patient experienced angina with ST-segment elevation, and the TTE showed de novo apical hypokinesia. The episode lasted approximately 10 minutes, with subsequent resolution of the ST-segment elevation. An emergency coronary angiogram revealed dissection of the left anterior descending artery. A conservative approach with aspirin monotherapy was chosen. Follow-up TTE at 3 months revealed full recovery of left ventricular function. A multidisciplinary approach is crucial in pregnancy-associated SCAD. Conservative management is generally recommended because of the potential for angiographic healing, with percutaneous coronary intervention reserved for severe cases.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 2","pages":"Article 102769"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775801/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Case reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666084924008052","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

We report a case of spontaneous coronary dissection (SCAD) in a 32-year-old pregnant patient during the seventh month of her second pregnancy. A 32-year-old pregnant woman in the 28th week of gestation was referred to our intensive care unit because of angina as well as elevated troponin levels. The initial electrocardiogram and transthoracic echocardiogram (TTE) were normal. Four hours after admission, the patient experienced angina with ST-segment elevation, and the TTE showed de novo apical hypokinesia. The episode lasted approximately 10 minutes, with subsequent resolution of the ST-segment elevation. An emergency coronary angiogram revealed dissection of the left anterior descending artery. A conservative approach with aspirin monotherapy was chosen. Follow-up TTE at 3 months revealed full recovery of left ventricular function. A multidisciplinary approach is crucial in pregnancy-associated SCAD. Conservative management is generally recommended because of the potential for angiographic healing, with percutaneous coronary intervention reserved for severe cases.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊