Peripartum acute anterior ST segment elevation myocardial infarction: an uncommon presentation of acute aortic dissection

ABSTRACT

<p><b>INTRODUCTION</b>Atherosclerotic coronary artery thrombosis is the most common cause of acute myocardial infarction.</p><p><b>CLINICAL PICTURE</b>A 30-year-old lady presented with acute peripartum massive anterior ST segment myocardial infarction and cardiogenic shock. This was due to acute Stanford type A aortic dissection with the intimal flap occluding the left coronary ostium. The initial diagnosis was not apparent. Echocardiography confirmed the diagnosis.</p><p><b>TREATMENT AND OUTCOME</b>She underwent emergency surgical repair (Bentall procedure). Pathology confirmed underlying idiopathic cystic medial degeneration.</p><p><b>CONCLUSION</b>A high index of clinical suspicion is required in acute myocardial infarction presenting without traditional cardiovascular risk factors.</p>