Internal Medicine: Open Access
Open Access
ISSN: 2165-8048
+44 1300 500008
ISSN: 2165-8048
+44 1300 500008
Yeshwanth Kempanna
James Paget University Hospital, UK
Scientific Tracks Abstracts: Intern Med
Introduction: Spontaneous coronary artery dissection (SCAD) is an important cause of acute myocardial infarction in pregnant and puerperium. It leads to significant maternal and foetal mortality if not recognised early. Although the exact cause is unknown, affected patients are often young, otherwise healthy women with few or no risk factors for heart disease. About 26-38% of cases are related to pregnancy and puerperium. The hormonal surge during pregnancy has shown to cause structural changes in the vessel wall leading to SCAD. On reviewing literature, less than 10 cases of twin-pregnancy with SCAD has been reported Case: This is a rare case of SCAD in twin pregnancy where a 32 year-old Gravida4 Para2 and at 17 weeks of diamniotic dichorionic gestation, presented to ED and arrested after complaining of chest pain and shortness of breath. Post resuscitation Coronary angiography showed LAD Coronary artery dissection. The patient was successfully managed medically through a multidisciplinary approach, followed up through the antenatal period and delivery was uneventful with birth of healthy twins. Conclusion: The spontaneous occurrence without warning signs, absence of heart disease risk factors and frequent association with pregnancy makes it important to have an index of suspicion of SCAD in any pregnant woman presenting with chest pain. Timely recognition and prompt treatment with a multidisciplinary support is of paramount importance for a successful outcome for such cases
Yeshwanth Kempanna is an International Training Fellow in Emergency Medicine at the James Paget University Hospital, NHS, United Kingdom with nearly six years of experience in Emergency Medicine that includes his practice in India and the UK.