title: Acute myocardial infarction caused by multivessel spontaneous coronary artery dissection in a postpartum woman.
abstract: Spontaneous coronary artery dissection is a rare cause of acute ischemic coronary events and sudden cardiac death. It usually occurs in young women not experiencing traditional risk factors for coronary artery disease during pregnancy or postpartum period. The pathophysiology of spontaneous arterial dissection remains uncertain and the management may be challenging. Herein, we report a case of a 41-year woman with no apparent cardiovascular risk factors, who underwent a successfull in vitro fertilization and embryo transfer with a subsequent at term cesarean section of a twin pregnancy. Six days after delivery, she presented with anterior ST-segment elevation myocardial infarction. Coronary angiography revealed dissection of all three coronary arteries with involvement of left main stem, which was successfully treated with percutaneous coronary intervention and drug-eluting stents implantation. The peculiarities of the case, toghether with the treatment strategy and the clinical and angiographic six-month follow-up are discussed.
authors: Division of Cardiology, Cardiac Catheterization Laboratory, Santa Maria delle Croci Hospital, Ravenna, Italy. sabinevecchio@gmail.com
authors: S
authors: S
authors: Vecchio
authors: E
authors: E
authors: Varani
authors: M
authors: M
authors: Balducelli
authors: M
authors: M
authors: Aquilina
authors: G
authors: G
authors: Vecchi
authors: M
authors: M
authors: Margheri
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications*; D003323:Coronary Aneurysm / Q000150:complications*; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology*; D011644:Puerperal Disorders / Q000209:etiology*