Postpartum spontaneous coronary, vertebral, and mesenteric artery dissections: a case report.
BACKGROUND
Spontaneous coronary artery dissection is a rare cause of myocardial infarction that must always be considered on a clinician's differential diagnosis, particularly in patients <50-years old with a paucity of typical vascular risk factors.


METHODS
We describe a case of a 33-year-old white woman, 3 weeks postpartum, presenting with retrosternal chest and back pain, neck pain and stiffness, and intermittent headaches. Subsequent workup revealed concurrent spontaneous dissections in three separate medium-sized arterial beds.


CONCLUSIONS
She was successfully managed in a conservative fashion, highlighting that percutaneous or surgical revascularization can often be foregone in favor of conservative medical therapy.
Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.|Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room D3 80, Toronto, Ontario, M4N 3M5, Canada.
Sean
S
Spence
Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.|Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room D3 80, Toronto, Ontario, M4N 3M5, Canada.
Maneesh
M
Sud
Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.|Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room D3 80, Toronto, Ontario, M4N 3M5, Canada.
Ravi
R
Bajaj
Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.|Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room D3 80, Toronto, Ontario, M4N 3M5, Canada.
Anna
A
Zavodni
Division of Rheumatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.|Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room D3 80, Toronto, Ontario, M4N 3M5, Canada.
Sharron
S
Sandhu
Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. mina.madan@sunnybrook.ca.|Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room D3 80, Toronto, Ontario, M4N 3M5, Canada. mina.madan@sunnybrook.ca.
Mina
M
Madan
D000328:Adult; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D049590:Postpartum Period; D011644:Puerperal Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014652:Vascular Diseases / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000503:physiopathology; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology
Acute myocardial infarction; Coronary artery dissection; Gender; Vertebral artery dissection