Aortic dissection in pregnancy.
BACKGROUND
Aortic dissection is a rare but life-threatening disease. The most common predisposing cause is chronic hypertension.


METHODS
A 38-year-old multipara with chronic hypertension was admitted at 38 weeks of gestation reporting new-onset severe chest pain. Cardiac enzymes, blood gases, electrocardiogram, and chest radiograph were normal. The chest pain and the hypertension worsened despite treatment with narcotics. Bedside transesophageal echocardiography revealed aortic dissection. Uneventful cesarean delivery was followed by surgical repair of the aorta.


CONCLUSIONS
Aortic dissection should be considered when a pregnant woman presents with preeclampsia superimposed on chronic hypertension and intractable chest pain.
Weissmann-Brenner
Alina
A
Department of Obstetrics and Gynecology, Lenox-Hill Hospital, New York, New York 10021, USA.
Schoen
Roy
R
Divon
Michael Y
MY
D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002585:Cesarean Section; D002637:Chest Pain / Q000209:etiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology