title: Spontaneous dissecting aneurysm of coronary artery in a pregnant woman at term.
abstract: We describe a case of spontaneous dissecting aneurysm of the circumflex coronary artery in a 44-year-old primigravida at term with no vascular risk factors. Spontaneous coronary artery dissection is a very rare condition with a greater prevalence in women, postpartum in particular. The left anterior descending artery is the most frequently affected. Histologically, the most common finding is a hematoma occupying the outer third of the media, resulting in complete compression of the true lumen. Arterial wall changes during pregnancy together with hemodynamic factors, a lytic action of protease released from eosinophils, and intimal tears are the main hypotheses considered to explain the etiology of spontaneous coronary artery dissection.
authors.affiliation: Institute of Anatomic Pathology and Histology, University of Perugia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bucciarelli
authors.forename: D
authors.initials: D
authors.lastname: Fratini
authors.forename: G
authors.initials: G
authors.lastname: Gilardi
authors.forename: G
authors.initials: G
authors.lastname: Affronti
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000473:pathology*; D003323:Coronary Aneurysm / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000473:pathology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000473:pathology*