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Program

Emergency Medicine

Training Level

Resident PGY 3

Institution

Henry Ford Macomb

Abstract

Spontaneous carotid artery dissection (SCAD) is a rare cause of myocardial infarction. It occurs more commonly in younger, female patients. SCAD is non-traumatic and non-iatrogenic. Most patients that experience SCAD do not have typical risk factors associated with CAD. Conditions that pre-dispose patients to SCAD includes postpartum status, multiparty, connective tissue disorders (Marfan, Ehlers-Danlos), systemic inflammatory conditions or hormonal therapy. Although rare, labor and delivery can be a cause of SCAD. Spontaneous coronary artery dissection is a cause of acute coronary syndrome in approximately 0.1 to 4% of cases. SCAD represents about 25% of ACS cases in women under 50.This case report involves a a 36 y.o. female with recent cesarean section that presents for chest pain. Diagnostic testing revealed an elevated troponin, elevated BNP and acute kidney injury. The patient underwent cardiac catheterization and was found to have a dissection of her coronary artery leading to acute congestive heart failure. The patient received supportive care and treatment of her CHF with improvement and eventually received stenting of her coronary artery. This case report focus on the presentation of this rare condition and discusses the recommended management.

Presentation Date

5-2020

Spontaneous Coronary Artery Dissection

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