Stroke secondary to post-partum coronary artery dissection.
BACKGROUND
There is an increased risk of stroke during pregnancy and the puerperium. This risk is greatest in the post-partum period. Embolic sources secondary to cardiac abnormalities and cerebral arterial dissection are recognized as potential etiologies.


METHODS
A 32-year-old woman presented with left-sided weakness eight days post-partum. Imaging studies identified infarction in the territory of the right middle cerebral artery. Cardiac investigations revealed acute myocardial infarction secondary to dissection of the left main coronary artery. The patient underwent coronary artery bypass grafting with significant recovery of cardiac function. At two years post-presentation, her neurological deficits have resolved.


CONCLUSIONS
Myocardial infarction secondary to coronary artery dissection has been long-recognized. Cerebral arterial dissection in association with pregnancy is also well-documented. This is a rare case of a patient presenting with stroke secondary to acute myocardial infarction secondary to coronary artery dissection.
Jaigobin
Cheryl
C
University of Toronto, Division of Neurology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Silver
Frank L
FL
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000473:pathology* / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D012739:Gonadal Steroid Hormones