Postpartum Acute Coronary Syndrome Due to Intramural Hematoma and Coronary Artery Dissection

Abstract

A 38-year-old woman presented with acute coronary syndrome 9 days postpartum. Coronary catheterization showed an intramural hematoma of the left main artery (LM) and the left anterior descending artery (LAD). During angiography, dissection of the LM, with involvement of the LAD and circumflex artery occurred. The patient presented unstable hemodynamic status. After resuscitation, intra-aortic balloon pump was inserted. The patient underwent two-vessel off-pump surgical revascularization. She was discharged 10 days later.

Keywords

coronary artery - coronary percutaneous interventions - coronary artery bypass grafting - complications

• References

• 1 Thayer JO, Healy RW, Maggs PR. Spontaneous coronary artery dissection. Ann Thorac Surg 1987; 44 (1) 97-102
• 2 Eby CS, McBride LR. Postpartum coronary artery dissection complicated by heparin-induced thrombocytopenia and thrombosis. Ann Thorac Surg 2001; 71 (3) 1025-1027
• 3 Koul AK, Hollander G, Moskovits N, Frankel R, Herrera L, Shani J. Coronary artery dissection during pregnancy and the postpartum period: two case reports and review of literature. Catheter Cardiovasc Interv 2001; 52 (1) 88-94
• 4 Engelman DT, Thayer J, Derossi J, Scheinerman J, Brown L. Pregnancy related coronary artery dissection: a case report and collective review. Conn Med 1993; 57 (3) 135-139
• 5 Barrett JM, Van Hooydonk JE, Boehm FH. Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv 1982; 37 (9) 557-566