|Summary of findings in post-partum spontaneous CAD and VAD cases|
|Motreff et al. (2010)||33 F G2P2||2 days post partum||● ECHO: LVEF 58%||● PCI with stent of RCA|
|● ACS 5 days post partum||● Medical management for VAD|
|● Vertebral artery dissection|
|Sharma et al. (2010)||28 F G2P2||10 days post partum||● Coronary CT Angiography: soft plaque in the LAD||● CABG involving LIMA to LAD and saphenous vein bypass graft to OM1|
|● Non-exertional, intermittent, sub-sternal, sharp chest pain, and left arm numbness||● Coronary angiogram: 90% eccentric stenosis in the ostial LAD extending to first septal perforator and dissection of the LCx||● In OR: Healed dissection in LCx and fresh dissection in LAD|
|● Intermittent bi-frontal headache||● IVUS: dissection flap in LAD with flow only in true lumen and intraluminal filling defect along entire course of LCx through AV groove||● Medical therapy: ASA Metoprolol, Simvastatin, Coumadin x 6 weeks|
|● EKG STEMI V1-V2||● MRA cervicocephalic vessels: 50% stenosis with a double lumen in mid-cervical left vertebral artery consistent with dissection||● MRA (6 weeks later): healed vertebral artery dissection and clinically free of symptoms|
|● CK and Troponin elevated|
|Cenkowski et al. (2012)||35 F G2P2||7 months post partum||● EKG: Inferior STEMI||7 months post partum|
|● Sudden onset retrosternal chest pain radiating to jaw, nausea, vomiting||● Coronary angiography: distal dissection of OM2||● Coronary artery dissection distal and not amenable to percutaneous repair|
|8 months post partum||● Transthoracic echo: mild hypokinesis basal inferior wall and EF 50-55%||● Medical therapy: ASA, Clopidogrel, Metoprolol, Ramipril, Simvastatin|
|● Diplopia, numbness to left arm and face||● CT angiography: 8mm dissection R vertebral artery in its V1 segment||● Medical therapy: Warfarin x 6 months in addition to ASA and Clopidogrel|
STEMI, ST elevation myocardial infarction; EF, ejection fraction; LAD, left anterior descending coronary artery; LCx, left circumflex coronary artery; OM2, second obtuse marginal branch; OM1, first obtuse marginal branch; CABG, coronary artery bypass graft; CT, computed tomography; LIMA, left internal mammary artery.
Cenkowski et al.
Cenkowski et al. BMC Pregnancy and Childbirth 2012 12:122 doi:10.1186/1471-2393-12-122