title: Spontaneous coronary artery dissection in a pregnant woman.
abstract: BACKGROUND
  Spontaneous coronary dissection is a rare condition occurring more often in women, with a higher frequency during the peripartum period. No specific etiology has been defined to describe this uncommon, yet often fatal phenomenon.
  
  
  METHODS
  A young woman presented at 36 weeks of a noncomplicated pregnancy with recent onset of diaphoresis, dyspnea, and tingling substernal chest discomfort. Upon evaluation, she developed cardiovascular collapse and ventricular fibrillation requiring aggressive resuscitative measures, eventually leading to extracorporeal membrane oxygenation. Right coronary artery dissection was ultimately diagnosed and treated with intracoronary angioplasty and stent placement.
  
  
  CONCLUSIONS
  Spontaneous coronary dissection must be considered when evaluating a patient with a similar clinical presentation, given its overall mortality of more than 50% at presentation, particularly in the peripartum period.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Michigan Hospitals, Ann Arbor, Michigan, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: McKechnie
authors.forename: D
authors.initials: D
authors.lastname: Patel
authors.forename: D T
authors.initials: DT
authors.lastname: Eitzman
authors.forename: S
authors.initials: S
authors.lastname: Rajagopalan
authors.forename: T H
authors.initials: TH
authors.lastname: Murthy
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000453:epidemiology / Q000628:therapy; D017130:Angioplasty; D003323:Coronary Aneurysm / Q000453:epidemiology / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000628:therapy; D015607:Stents