Coronary artery dissection in the puerperium. case report.

Abstract

 Coronary artery dissection is an uncommon pathology of acute coronary syndrome, which occurs mainly in women who have received hormonal therapy, are pregnant or in puerperium; its diagnosis is made by arteriography. We present the case of a 43-year-old woman and 35-weeks pregnant resulting from in vitro fertilization. She presented severe pre-eclampsia, for which she was taken to cesarean section and a total hysterectomy. In her postoperative period, she presented chest pain with electrocardiographic changes, and an arteriography was performed where dissection of the distal anterior descending coronary artery was documented. An Echocardiogram showed the presence of dyskinetic defect in the apical segment of the septal wall and the presence of aneurysmal pocket. The cardiology and hemodynamic departments consider that for the moment the patient benefits from conservative management.