Table 1 |
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| Summary of findings in post-partum spontaneous CAD and VAD cases | ||||
| Case | ID | Presentation | Imaging | Treatment/ Follow-up |
| 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. BMC Pregnancy and Childbirth 2012 12:122 doi:10.1186/1471-2393-12-122
