Unexpected acute aortic dissection after elective cesarean section delivery: Report of a case and review of the literature

Abstract

Acute aortic dissection may indeed be a rare complication of pregnancy, and the majority of aortic dissections usually occur during the third trimester of pregnancy. Most aortic dissections occur as a result of systemic hypertension or connective tissue disorders. Without any treatment, more than 50% of patients die within the initial 48 hours, and the 3-month mortality rate is as high as 90%. Because the pain in puerperal women is uncertain and diffi cult to discriminate from physiologic pain, the diagnosis of aortic dissection is complex and requires a high index of suspicion. We experienced a case of unexpected acute aortic dissection that occurred after elective cesarean section delivery in a young woman without any known risk factors. This case of aortic dissection was managed medically. In postpartum patients complaining of chest pain, the suspicion of aortic dissection is important for prompt diagnosis and better prognosis.

Postpartum aortic dissection in a patient without Marfan’s syndrome

“…Late presentation, delayed or misdiagnosis may be associated with postpartum aortic dissection because of its rarity ( 8 ) . The differential diagnoses of severe chest pain include acute myocardial infarction, pulmonary embolism, and aortic dissection ( 8 ) . Normal electrocardiogram cardiac enzymes are needed to exclude myocardial infarction.…”