Abstract
BackgroundSpontaneous coronary and vertebral artery dissections are rare events occurring most commonly in otherwise healthy women during pregnancy or the post-partum period.Case presentationThis report describes a 35-year-old female who presented with an acute inferior ST elevation myocardial infarction 7 months post-partum secondary to spontaneous dissection of the left obtuse marginal coronary artery. Despite appropriate medical therapy with dual anti-platelet therapy, the patient presented four weeks later with a spontaneous dissection of the right vertebral artery.ConclusionWe review the presentation, diagnosis, and management of spontaneous dissections of the vasculature in the peri-partum period.
Highlights
Spontaneous coronary and vertebral artery dissections are rare events occurring most commonly in otherwise healthy women during pregnancy or the post-partum period
Case presentation A 35 year old G2, P2 female presented with a two hour history of retrosternal chest discomfort radiating to the jaw, associated with nausea and diaphoresis
With the diagnosis of spontaneous dissection in two separate vascular territories, including the coronary and vertebral arteries, the patient was investigated with genetic testing to rule out any underlying collagen disorders including Ehlers Danlos and Marfan syndrome, which was within normal limits
Summary
Spontaneous coronary and vertebral artery dissections are rare events occurring most commonly in otherwise healthy women during pregnancy or the post-partum period. Case presentation A 35 year old G2, P2 female presented with a two hour history of retrosternal chest discomfort radiating to the jaw, associated with nausea and diaphoresis. She was 7 months post-partum and had no underlying cardiovascular risk factors. Computed tomographic angiography demonstrated a focal 8 mm long dissection of the right vertebral artery in its V1 segment with mild associated aneurysmal dilatation (Figure 1B). Vertebral arteries, the patient was investigated with genetic testing to rule out any underlying collagen disorders including Ehlers Danlos and Marfan syndrome, which was within normal limits. The patient was subsequently started on anticoagulation therapy to prevent future spontaneous dissections
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