Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Recurrent post-partum coronary artery dissection. | Rajab et al. Journal of Cardiothoracic Surgery 2010 5 78 http content 5 1 78 JOTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Recurrent post-partum coronary artery dissection 1 2 3 1 Taufiek K Rajab Zain Khalpey Bernhard Kraemer Frederic S Resnic Robert P Gallegos Abstract Coronary artery dissection is a rare but well-described cause for myocardial infarction during the post-partum period. Dissection of multiple coronary arteries is even less frequent. Here we present a case of recurrent post-partum coronary artery dissections. This unusual presentation poses unique problems for management. A 35 year-old female gravida 3 para 2 presented with myocardial infarction 9 weeks and 3 days post-partum. Cardiac catheterization demonstrated left anterior descending LAD dissection but an otherwise normal coronary anatomy. The lesion was treated with four everolimus eluting stents. Initially the patient made an unremarkable recovery until ventricular fibrillation arrest occurred on the following day. Unsynchronized cardioversion restored a normal sinus rhythm and repeat catheterization revealed new right coronary artery RCA dissection. A wire was passed distally but it was unclear whether this was through the true or false lumen and no stents could be placed. However improvement of distal RCA perfusion was noted on angiogram. Despite failure of interventional therapy the patient was therefore treated conservatively. Early operation after myocardial infarction has a significantly elevated risk of mortality and the initial dissection had occurred within 24 hours. This strategy proved successful as follow-up transthoracic echocardiography after four months demonstrated a preserved left ventricular ejection fraction of 55-60 without regional wall motion abnormalities. The patient remained asymptomatic from a cardiac point of view. Background Myocardial infarctions in women of childbearing age are rare. Myocardial infarctions related
