Pregnancy-associated spontaneous coronary artery dissection: insights from a case series of 13 patients
Eur Heart J Cardiovasc Imaging
; 18(1): 54-61, 2017. ilus, tab
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1062603
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
AIMS:
We sought to present a series of 13 pregnancy-associated spontaneous coronary artery dissection (P-SCAD), their angiographic and multimodal imaging findings, acute phase treatment, and outcomes. METHODS ANDRESULTS:
Between 2005 and 2015, 13 cases of P-SCAD were collected from a database of 11 tertiary hospitals. The mean age was 33.8 ± 3.7 years; most patients had no risk factors for coronary artery disease, and the majority were multiparous. P-SCAD occurred during the puerperium in 12 patients with a median time of 10 days. Only one patient presented with P-SCAD in the 37th week of pregnancy, and she was the only patient who died in this series. Six patients (46%) presented with ST-segment elevation acute myocardial infarction (STEMI), six (46%) presented with non-STEMI, and one presented with unstable angina; one-third of women had cardiogenic shock. In 12 patients, the dissection involved the left anterior descending or circumflex artery, and it extended to the left main coronary artery in 6 patients. Intravascular ultrasound or optical coherence tomography helped to confirm diagnosis and guide treatment in 46% of cases. Seven women were managed clinically; percutaneous coronary intervention was performed in five cases, and coronary artery bypass grafting was performed in one patient...
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Collection:
National databases
/
Brazil
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Ultrasonography, Interventional
/
Carotid Artery, Internal, Dissection
/
Myocardial Infarction
Language:
English
Journal:
Eur Heart J Cardiovasc Imaging
Year:
2017
Document type:
Article
Institution/Affiliation country:
Clínica São Vicente/BR
/
Escola Paulista de Medicina, Universidade Federal de São Paulo/BR
/
Hospital Bandeirantes/BR
/
Hospital Israelita Albert Einstein/BR
/
Hospital Regional de Mato Grosso do Sul/BR
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Mount Sinai Medical Center/US
/
Santa Casa de Misericórdia de Goiânia/BR