title: Peripartum acute anterior ST segment elevation myocardial infarction: an uncommon presentation of acute aortic dissection.
abstract: BACKGROUND
  Atherosclerotic coronary artery thrombosis is the most common cause of acute myocardial infarction.
  
  
  METHODS
  A 30-year-old lady presented with acute peripartum massive anterior ST segment myocardial infarction and cardiogenic shock. This was due to acute Stanford type A aortic dissection with the intimal flap occluding the left coronary ostium. The initial diagnosis was not apparent. Echocardiography confirmed the diagnosis.
  
  
  RESULTS
  She underwent emergency surgical repair (Bentall procedure). Pathology confirmed underlying idiopathic cystic medial degeneration.
  
  
  CONCLUSIONS
  A high index of clinical suspicion is required in acute myocardial infarction presenting without traditional cardiovascular risk factors.
authors.affiliation: Cardiac Department, National University Hospital, Singapore. abdul_razakjr_bin_omar@nuh.com.sg
authors.forename: Abdul Razakjr
authors.initials: AR
authors.lastname: Omar
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Goh
authors.forename: Yean-Teng
authors.initials: YT
authors.lastname: Lim
mesh_terms: D000208:Acute Disease; D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D012770:Shock, Cardiogenic / Q000209:etiology