SPONTANEOUS RIGHT CORONARY ARTERY DISSECTION IN A NORMOTENSIVE POST-PARTUM FEMALE

Authors

  • Rizwan Ishtiaq Bahawal Victoria Hospital
  • Asim Saddique District Teaching Hospital, Sargodha
  • Ali Akram District Teaching Hospital, Sargodha
  • Mariam Arif District Teaching Hospital, Sargodha
  • Fida Muhammad District Teaching Hospital, Sargodha
  • Umer Hassan Chaudhry Bahawal Victoria Hospital, Bahawalpur

Abstract

Acute myocardial infarction following coronary artery dissection during the post-partum period is a rare entity. Greater hemodynamic stress and hormonal changes increase the risk of developing a coronary artery dissection post-partum. Herein, we report the first case of a normotensive patient from Pakistan that presented with inferior wall myocardial infarction following 10-days post-partum due to right coronary artery dissection. This article highlights the importance of prompt diagnosis and subsequent life-saving treatment.Keywords: myocardial infarction; post-partum; coronary artery dissection; right coronary artery

Author Biographies

Rizwan Ishtiaq, Bahawal Victoria Hospital

Internal Medicine

Asim Saddique, District Teaching Hospital, Sargodha

Senior Registrar Cardiology

Ali Akram, District Teaching Hospital, Sargodha

Internal Medicine

Mariam Arif, District Teaching Hospital, Sargodha

Internal Medicine

Fida Muhammad, District Teaching Hospital, Sargodha

Assistant Professor Cardiology

Umer Hassan Chaudhry, Bahawal Victoria Hospital, Bahawalpur

General Surgery

References

Roth A, Elkayam U. Acute myocardial infarction associated with pregnancy. Ann Intern Med 1996;125(9):751–62.

Goel K, Tweet M, Olson TM, Maleszewski JJ, Gulati R, Hayes SN. Familial spontaneous coronary artery dissection: evidence for genetic susceptibility. JAMA Intern Med 2015;175(5):821–6.

Pretty HC. Dissecting aneurysm of coronary artery in a woman aged 42: rupture. Br Med J 1931;1:667.

Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ, et al. Clinical features, management and prognosis of spontaneous coronary artery dissection. Circulation 2012;126(5):579–88.

Evans R. Post‐partum spontaneous coronary artery dissection and the use of veno‐arterial extra‐corporeal membrane oxygenation. Nurs Crit Care 2014;19(6):304–9.

Balogun-Lynch J, Shah H, Porter B. Coronary artery dissection in the postpartum period. BMJ Case Rep 2014;2014:bcr2014206658.

Lezcano Gort LE, Romani SA, Rodriguez Carreras CR. Postpartum multivessel spontaneous coronary artery dissection. Rev Esp Cardiol 2016;69(8):781–2.

Kamineni R, Sadhu A, Alpert JS. Spontaneous coronary artery dissection: report of two cases and a 50-year review of the literature. Cardiol Rev 2002;10(5):279–84.

Henkin S, Negrotto SM, Tweet MS, Kirmani S, Deyle DR, Gulati R, et al. Spontaneous coronary artery dissection and its association with heritable connective tissue disorders. Heart 2016;102(11):876–81.

Thompson EA, Ferraris S, Gress T, Ferraris V. Gender differences and predictors of mortality in spontaneous coronary artery dissection: a review of reported cases. J Invasive Cardiol 2005;17(1):59–61.

Chou AY, Saw J. Basis for sex-specific expression of Takotsubo cardiomyopathy, cardiac syndrome X, and spontaneous coronary artery dissection. Can J Cardiol 2014;30(7):738–46.

Vrints CJ. Spontaneous coronary artery dissection. Heart 2010;96(10):801–8.

Manalo-Estrella P, Barker AE. Histopathologic findings in human aortic media associated with pregnancy. Arch Pathol 1967;83(4):336–41.

Wingrove CS, Garr E, Godsland IF, Stevenson JC. 17β-Oestradiol enhances release of matrix metalloproteinase-2 from human vascular smooth muscle cells. Biochim Biophys Acta 1998;1406(2):169–74.

Elkayam U, Gleicher N. Cardiac problems in pregnancy: Diagnosis and management of maternal and fetal heart disease. John Wiley & Sons; 1998.

Robinowitz M, Virmani R, McAllister HA JrU. Spontaneous coronary artery dissection and eosinophilic inflammation: a cause and effect relationship? Am J Med 1982;72(6):923–8.

Saw J, Aymong E, Sedlak T, Buller CE, Starovoytov A, Ricci D, et al. Spontaneous Coronary Artery Dissection. Circulation: Cardiovasc Interv 2014;7(5):645–55.

Higgins GL, Borofsky JS, Irish CB, Cochran TS, Strout TD. Spontaneous peripartum coronary artery dissection presentation and outcome. J Am Board Fam Med 2013;26(1):82–9.

Wain-Hobson J, Roule V, Dahdouh Z, Sabatier R, Lognoné T, Grollier G. Spontaneous coronary artery dissection: one entity with several therapeutic options. Cardiovas Revasc Med 2012;13(3):203.

Appleby CE, Barolet A, Ing D, Ross J, Schwartz L, seidelin P, et al. Contemporary management of pregnancy-related coronary artery dissection: A single-centre experience and literature review. Exp Clin Cardiol 2009;14(1):e8–16.

Lin AH, Shutt BJ, Dendall RT, Bennett W. Multivessel spontaneous coronary artery dissection treated with staged percutanous coronary intervention in a non-postpartum female. BMJ Case Rep 2012;2012:bcr2012007274.

Hunt B, Chua R, Bett N. Conservative treatment of spontaneous dissection of multiple coronary arteries. Heart Lung Circ 2010;19(11):678–80.

Mortensen KH, Thuesen L, Kristensen IB, Christiansen EH. Spontaneous coronary artery dissection: a Western Denmark Heart Registry study. Catheter Cardiovasc Interv 2009;74(5):710–7.

Moukarbel GV, Alam SE. Spontaneous Coronary Artery Dissection: Management Options in the stent era. J Inveasive Cardiol 2004;16(6):333–5.

De Bono D. Complications of diagnostic cardiac catheterisation: results from 34,041 patients in the United Kingdom confidential enquiry into cardiac catheter complications. The Joint Audit Committee of the British Cardiac Society and Royal College of Physicians of London. Br Heart J 1993;70(3):297–300.

Shahzad K, Cao L, Ain QT, Waddy J, Khan N, Nekkanti R. Postpartum spontaneous dissection of the first obtuse marginal branch of the left circumflex coronary artery causing acute coronary syndrome: a case report and literature review. J Med Case Rep 2013;7(1):82.

Saw J. Spontaneous coronary artery dissection. Can J Cardiol 2013;29(9):1027–33.

Published

2018-03-16

Issue

Vol. 30 No. 2 (2018): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

CASE REPORT

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