A Case Study of Spontaneous Coronary Artery Dissection in 35-Year-Old Postpartum female

 Mohammed Al-Goby1*, Eyas N. Al- Mousa2

1Department of Internal Medicine, Faculty of Medical and Health Sciences, Sana'a University,

2Cardiology Department, Jordanian University Hospital


Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden cardiac death1. It should be suspected in every healthy young woman without cardiac risk factors, especially during the peripartum or postpartum periods. It is important to check for a history of drug abuse, collagen vascular disease, or blunt trauma of the chest. Coronary angiography is crucial in the diagnosis of SCAD. intravascular ultrasonography and multislices CT-scan (MSCT) are other diagnostic methods2. Generally, there is no consensus on the etiology, prognosis, and treatment of SCAD3. Conservative treatment is suggestive for managing stable, asymptomatic patients. Stents have been implanted successfully in selected cases where the true lumen and false lumens were clearly distinguishable and the dissecting flap did not involve a long segment. Coronary artery bypass surgery (CABG) is recommended when the dissection involves the left main coronary artery (LMCA)

or multiple vessels or when percutaneous intervention fails2. This report describes a 35 year old post-partum woman diagnosed as SCAD of left anterior descending artery (LAD), treated successfully by implantation of 2 bare metal stents. The aim of reporting this case is that in females at prepartum period without identifiable CAD risk factors with ischemic chest pain SCAD should be suspected and considered in the differential diagnosis.

Case Report

A 35-year Jordanian woman with no identifiable coronary risk factors, and no history of drug abuse, collagen vascular disease, or chest traum admitted to the Coronary Care Units (CCU) of Jordan University Hospital (JUH) with history of recurrent attacks of retrosternal ischemic chest pain at rest radiated to the left arm of two months duration. Two months earlier (four days post normal vaginal delivery), she was admitted to the CCU of the Prince Eman Hospital in Ajloon, Jordan complaining of,

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An Academic Biannual Refereed Journal, Published by Sana'a University

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