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Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome (ACS), particularly in postpartum women without traditional cardiac risk factors. Our case involves a 29-year-old postpartum woman who presented with severe substernal chest pain eight days after an emergency cesarean section for pregnancy-associated hypertension. Electrocardiography showed ST elevation in the inferior and posterior leads, and coronary angiography revealed a spontaneous dissection in the left circumflex artery (LCx) with an intramural hematoma, alongside a dissection of the right coronary artery (RCA) extending from the ostium to the mid-vessel.

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Article Synopsis
  • Spontaneous coronary artery dissection (SCAD) is a significant cause of heart issues in young women, especially postpartum, and Pregnancy-Associated SCAD (P-SCAD) is a severe subtype.
  • A case study highlighted a 40-year-old Haitian woman with postpartum pre-eclampsia who experienced multi-vessel SCAD, diagnosed using coronary angiography.
  • The patient stayed stable without intervention but developed recurrent chest pain, treated with clopidogrel; the link between pre-eclampsia and SCAD risk needs more research.
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Pathophysiology of Preeclampsia-Induced Vascular Dysfunction and Implications for Subclinical Myocardial Damage and Heart Failure.

JACC Adv

June 2024

Raquel and Jaime Gilinski Department of Obstetrics, Gynecology, and Reproductive Science, New York, New York, USA.

Article Synopsis
  • - Preeclampsia is a major pregnancy complication that significantly increases the risk of cardiovascular disease (CVD) for both mothers and infants, especially among Black women.
  • - Early preeclampsia, occurring before 34 weeks of gestation, leads to systemic vascular issues that can cause lasting heart damage and pose long-term risks for heart failure (HF).
  • - It’s important for women who experienced early or severe preeclampsia to receive careful monitoring after pregnancy to manage chronic hypertension and decrease the risks of CVD and HF.
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