TABLE 1.
Spontaneous coronary artery dissection related to pregnancy and the postpartum period
| Case number (reference) | Year | Age, years | Gravida/para | Risk factors | Event time | Presentation | Vessel involved | Treatment strategy | Status of patient, status of fetus (if pregnant) |
|---|---|---|---|---|---|---|---|---|---|
| Case series | |||||||||
| 1 | 2008 | 34 | 2/2 | None | 7 days PP | Anterior STEMI | LAD | PCI (BMS), repeat PCI (DES) | Alive |
| 2 | 2007 | 31 | 2/2 | None | 8 days PP | NSTEMI | RCA | PCI (BMS) | Alive |
| 3 | 2005 | 30 | 2/1 | †Cholesterol | 5 days PP | Anterior STEMI, shock | LAD | PCI, transplant | Alive |
| 4 | 2004 | 26 | 1/1 | None | 3 months PP | Anterior STEMI | LAD | Medical | Alive |
| 5 (7) | 2002 | 33 | 2/1 | None | 24-week gest | NSTEMI | LMS, LAD, Cx, RCA later | CABG | Alive, fetal loss |
| Published case reports | |||||||||
| 6 (38) | 1999 | 31 | Smoker | 4 days PP | Anterior STEMI | LAD | PCI (BMS) | Alive | |
| 7 (39) | 1999 | 29 | 1/1 | None | 23-week gest | Inferior STEMI | RCA, LAD | PCI (BMS) | Alive, cesarean section, status unknown |
| 8 (21) | 2008 | 34 | Hypertension, smoker, NIDDM | 34-week gest | Anterior STEMI | LAD, Cx | CABG on CPB | Alive, healthy baby | |
| 9 (40) | 2008 | 33 | None | 1st trimester | Inferior STEMI | RCA, LAD | Not discussed | Alive, therapeutic abortion | |
| 10 (30) | 2006 | 23 | Smoker | 2 months postabortion (14-week gest) | Anterior STEMI, shock | LMS, LAD and Cx. RCA at 18 months | PCI (BMS) | Alive | |
| 11 (41) | 2001 | 36 | None | 36-week gest | Inferior STEMI, shock | RCA | PCI (BMS) | Alive, healthy baby | |
| 12 (37) | 2007 | 36 | None | 36-week gest | Anterior STEMI, shock | LAD, Cx | CABG off pump | Alive, healthy baby | |
| 13 (31) | 2005 | 37 | 3/2 | None | 2 months PP | Anterior STEMI | LAD | Medical | Alive |
| 14 (42) | 2007 | 29 | None | 1 day PP | NSTEMI, shock | LMS | CABG on CPB | Alive | |
| 15 (43) | 2006 | 31 | 2/2 | None | 3 days PP | Anterior STEMI | LMS, LAD | PCI (DES) | Alive |
| 16 (44) | 2006 | 38 | 2/1 | †Cholesterol, family history | 34-week gest | Anterior STEMI | LAD | Medical | Alive, cesarean section, twins, healthy |
| 17 (22) | 2005 | 22 | 1/1 | Smoker | 10 days PP | NSTEMI | LAD | Medical | Alive |
| 18 (45) | 2004 | 31 | 5/2 | None | 8 days PP | Anterior STEMI | LAD | Medical | Alive |
| 19 (46) | 2002 | 36 | 3/3 | Family history, hypertension | 4 weeks PP | Anterior STEMI | LAD | Medical | Alive |
| 20 (1) | 2002 | 34 | Smoker | 5 days PP | Anterior STEMI | LAD | PCI (BMS) | Alive | |
| 21 (29) | 2001 | 37 | 2/1 | Smoker | 4 days PP | Anterior STEMI | LAD, Cx | PCI, then CABG on CPB | Alive |
| 22 (47) | 2006 | 38 | 2/2 | None | 2 weeks PP | NSTEMI | LAD | CABG on CPB | Alive |
| 23 (48) | 2006 | 23 | 2/2 | None | 8 days PP | Anterior STEMI | LMS | CABG on CPB | Alive |
| 24 (49) | 2005 | 36 | 4/1 | None | 34-week gest | Inferior STEMI | RCA | PCI (DES) | Alive, healthy baby |
| 25 (50) | 2007 | 34 | 4/3 | None | 32-week gest | Inferior STEMI | RCA | PCI (BMS) | Alive, healthy baby |
BMS Bare metal stents; CABG Coronary artery bypass graft; CPB Cardiopulmonary bypass; Cx Circumflex; DES Drug-eluting stents; gest Gestation; LAD Left anterior descending; LMS Left main stem; NIDDM Non-insulin-dependent diabetes mellitis; NSTEMI Non-ST elevation myocardial infarction; PCI Percutaneous coronary intervention; PP Postpartum; RCA Right coronary artery; STEMI ST elevation myocardial infarction;