Spontaneous coronary artery dissection following induced vaginal delivery.

Abstract

Cardiovascular diseases represent a significant threat to the health and life of women during pregnancy and the postpartum period, accounting for 13% of all maternal deaths and constituting the third most common cause of perinatal mortality. A particular cause of myocardial infarction in young women, including pregnant patients, is spontaneous coronary artery dissection (SCAD).The occurrence of spontaneous coronary artery dissection may be preceded by triggering factors such as intense physical exertion, intense Valsalva manoeuvres, emotional or physical stress, labour, as well as exposure to exogenous hormones and β hCG. Despite the increasing number of reported cases, the true incidence of pregnancy related SCAD remains unknown. The presented clinical case describes an acute coronary syndrome in a 32-year-old woman in the early postpartum period, secondary to spontaneous coronary artery dissection. The patient was qualified for urgent coronary angiography, which revealed critical, ninety-percent stenosis of the left anterior descending coronary artery (LAD). Following percutaneous transluminal coronary angioplasty, effective myocardial reperfusion was achieved. Young women with low cardiovascular risk and without clinically significant risk factors may develop acute myocardial ischaemia.