Spontaneous coronary dissection during postpartum: etiology and controversies in management.
A 31-year-old female with a history of toxic oil syndrome in childhood, presented with spontaneous left main coronary dissection 4 weeks after an uncomplicated delivery. She had an extensive myocardial infarction, severe left ventricular dysfunction and cardiogenic shock which did not resolve following urgent surgical revascularization. Temporary left ventricular support and heart transplantation were necessary. We analyze the etiology and treatment sequence in what to our knowledge is the first case with these characteristics to be reported.
Division of Cardiac Surgery, ICICOR, University Hospital, Valladolid, Spain. aguerrerop@medynet.com
Yolanda Carrascal
YC
Hinojal
Salvatore
S
Di Stefano
Santiago
S
Florez
Gerardo
G
Martínez
Luis
L
de la Fuente
Elena
E
Casquero
Javier
J
Gualis
D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000379:methods*; D006353:Heart-Assist Devices; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000379:methods; D049590:Postpartum Period; D011859:Radiography; D035583:Rare Diseases; D018570:Risk Assessment; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome