Coronary artery dissection during pregnancy and the postpartum period: Two case reports and review of literature

Koul, Ashok K.; Hollander, Gerald; Moskovits, Norbert; Frankel, Robert; Herrera, Leo; Shani, Jacob

doi:10.1002/1522-726x(200101)52:1<88::aid-ccd1022>3.0.co;2-p

Cited by 205 publications

(216 citation statements)

References 40 publications

(13 reference statements)

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“…Case 1 was four months postpartum. Because haemodynamic stress is no longer encountered four months after delivery and arterial wall changes have returned to normal, 6,7 we doubt that this patient belongs to the peripartum group. In addition, there were no signs of connective tissue disorders, SLE or atherosclerosis.…”

Section: Treatment and Diagnostic Work-upmentioning

confidence: 85%

“…The peak incidence is in the second week after delivery. 6 The earliest reported case occurred within nine weeks of conception and the last three months postpartum. Only 30% of the patients in this group had known risk factors for coronary artery disease.…”

Section: Peripartum Episodementioning

confidence: 99%

“…Only 30% of the patients in this group had known risk factors for coronary artery disease. 6 The role of the peripartum period in the pathogenesis is still unclear. Changes in the levels of sex hormones are considered to play an important role.…”

Section: Peripartum Episodementioning

confidence: 99%

“…6 Patients with atherosclerosis as an underlying disease are thought to have a better prognosis due to collateral circulation which may develop due to chronic atherosclerosis. 13 Also men tend to have a better chance of survival compared with women, who have an even worse prognosis when they are not in the peri-or postpartum period.…”

Section: Prognosismentioning

confidence: 99%

“…This hypothesis is confirmed by the observation that in more than 40% of pregnant SCAD patients, dissections could be demonstrated in more than one vessel. 6 So it seems that there is a systemic susceptibility to dissections at a certain point in life, which is marked by the initial event. Therefore we recommend monitoring patients with SCAD for at least one week in the hospital.…”

Section: Prognosismentioning

confidence: 99%

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Spontaneous coronary artery dissection: current insights and therapy

Tanis¹,

Stella²,

Pijlman³

et al. 2008

NHJL

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Spontaneous coronary artery dissection (SCAD) is a very rare cause of acute coronary syndromes in young otherwise healthy patients with a striking predilection for the female gender. The pathological mechanism has not been fully clarified yet. However, several diseases and conditions have been associated with SCAD, such as atherosclerosis, connective tissue disorders and the peripartum episode. In this paper we present a review of the literature, discussing the possible mechanisms for SCAD, therapeutic options and prognosis. The review is illustrated with two SCAD patients who had a recurrence of a spontaneous dissection in another artery within a few days after the initial event. Because of the susceptibility to recurrent spontaneous dissections we propose at least one week of observation in hospital. Further, we will elaborate on the possible conservative and invasive treatment strategies in the acute phase of SCAD. Primary percutaneous coronary intervention remains the reperfusion strategy of choice; however, in small and medium-sized arteries with normalised flow conservative treatment is defendable. In addition, after the acute phase evaluation of possible underlying diseases is necessary, because it affects further treatment. (Neth Heart J 2008;16:344-9.)

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Section: Treatment and Diagnostic Work-upmentioning

confidence: 85%

Section: Peripartum Episodementioning

confidence: 99%

Section: Peripartum Episodementioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

See 3 more Smart Citations