title: Spontaneous multiarterial dissection immediately after childbirth.
abstract: Spontaneous coronary artery dissection and vertebral artery dissection are rare, life-threatening conditions. The pathophysiology of spontaneous coronary artery dissection during the peripartum period is poorly understood. We present a case of spontaneous multivessel dissection in a 32-year-old postpartum woman who presented with neck and chest pain. The patient's coronary and vertebral artery dissections were diagnosed with use of multiple imaging methods, and dissection of the internal mammary artery was discovered during surgery. The patient underwent successful coronary artery bypass grafting and remained asymptomatic 2 years later. To our knowledge, this is the first report of simultaneous coronary, vertebral, and internal mammary artery dissection in a postpartum woman. Early recognition and treatment is crucial, given the high mortality rate associated with spontaneous dissection.
authors.affiliation: Department of Cardiovascular Sciences, Brody School of Medicine at East Carolina University, Greenville, North Carolina 27834, USA. brantleyh@ecu.edu
authors.forename: Hutton P
authors.initials: HP
authors.lastname: Brantley
authors.forename: Brian R
authors.initials: BR
authors.lastname: Cabarrus
authors.forename: Assad
authors.initials: A
authors.lastname: Movahed
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D036801:Parturition; D049590:Postpartum Period; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
keywords: Acute coronary syndrome/etiology; coronary artery bypass; postpartum period; pregnancy complications, cardiovascular/diagnosis; rupture, spontaneous/diagnosis/etiology/surgery; treatment outcome; vertebral artery dissection/epidemiology/surgery/ultrasonography