title: A case of postpartum spontaneous coronary artery dissection.
abstract: Spontaneous coronary artery dissection is rare and usually affects younger women in the peripartum period. Here, we report an interesting case of a 34-year-old woman with spontaneous coronary artery dissection that occurred 1 month after childbirth. Emergency coronary angiography showed stenosis of the left anterior descending artery, but immediately afterwards, a new occlusion of the right coronary artery occurred. Intravascular ultrasound was used to image both right and left coronary arteries. The new occlusion of the right coronary artery was probably iatrogenic, but the left coronary artery occlusion was spontaneous. The patient underwent percutaneous coronary intervention in the right coronary artery because of her unstable hemodynamic condition. Revascularization of the left coronary artery was performed by bypass grafting. The patient was discharged on postoperative day 30. As the optimal treatment for spontaneous coronary artery dissection has not yet been established, treatments should be based on the patient's clinical presentation.
authors.affiliation: Department of Cardiovascular Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuou-ku, Kumamoto, 860-0008, Japan, mutsuoman620@gmail.com.
authors.forename: Minoru
authors.initials: M
authors.lastname: Okamoto
authors.forename: Mutsuo
authors.initials: M
authors.lastname: Tanaka
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ishii
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Honda
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Koga
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyao
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Murayama
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods*; D003331:Coronary Vessels / Q000601:surgery*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D049590:Postpartum Period