Peripartum acute anterior ST segment elevation myocardial infarction: an uncommon presentation of acute aortic dissection.
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.
Omar
Abdul Razakjr
AR
Cardiac Department, National University Hospital, Singapore. abdul_razakjr_bin_omar@nuh.com.sg
Goh
Wei-Ping
WP
Lim
Yean-Teng
YT
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