title: Staged therapeutic approach in spontaneous coronary dissection.
abstract: Spontaneous coronary artery dissection is an extremely rare event occurring especially in pregnant women, either peripartum or postpartum. Urgent coronary angiography has to be performed to confirm the diagnosis and to determine the appropriate therapeutic strategy. We present the case of a 36-year-old woman in week 36 of her pregnancy who was admitted in cardiogenic shock due to an acute anterolateral myocardial infarction as a result of spontaneous coronary artery dissection. While she was on aortic balloon counterpulsation the patient underwent a cesarean section and gave birth to a healthy child. Subsequently she successfully underwent off-pump coronary artery bypass surgery.
authors.affiliation: Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Siamak
authors.initials: S
authors.lastname: Aliyary
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Mariani
authors.forename: Patrick M J
authors.initials: PM
authors.lastname: Verhorst
authors.forename: Marc
authors.initials: M
authors.lastname: Hartmann
authors.forename: Martin G
authors.initials: MG
authors.lastname: Stoel
authors.forename: Clemens
authors.initials: C
authors.lastname: von Birgelen
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D002585:Cesarean Section; D003323:Coronary Aneurysm / Q000150:complications / Q000601:surgery*; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D007423:Intra-Aortic Balloon Pumping; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D012008:Recurrence; D012422:Rupture, Spontaneous; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy