Pregnancy-Associated Spontaneous Coronary Dissection in a 32-Year-Old During the Third Trimester

Overview

Journal JACC Case Rep

Date 2025 Jan 31

PMID 39886423

Authors

Nikolaos Tsianakas

Frank Oehmke

Vera Muller

Jakob Lorenz

Holger Nef

Christian Hamm

Samuel Sossalla

Michael Sander

Ivo Meinhold-Heerlein

Oliver Dorr

Affiliations

Soon will be listed here.

Abstract

We report a case of spontaneous coronary dissection (SCAD) in a 32-year-old pregnant patient during the seventh month of her second pregnancy. A 32-year-old pregnant woman in the 28th week of gestation was referred to our intensive care unit because of angina as well as elevated troponin levels. The initial electrocardiogram and transthoracic echocardiogram (TTE) were normal. Four hours after admission, the patient experienced angina with ST-segment elevation, and the TTE showed de novo apical hypokinesia. The episode lasted approximately 10 minutes, with subsequent resolution of the ST-segment elevation. An emergency coronary angiogram revealed dissection of the left anterior descending artery. A conservative approach with aspirin monotherapy was chosen. Follow-up TTE at 3 months revealed full recovery of left ventricular function. A multidisciplinary approach is crucial in pregnancy-associated SCAD. Conservative management is generally recommended because of the potential for angiographic healing, with percutaneous coronary intervention reserved for severe cases.

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