Resumo

CARDENAS FERNANDEZ, Yoanis et al. Spontaneous dissection of coronary arteries in the puerperium. Case report. CorSalud [online]. 2019, vol.11, n.2, pp. 179-183. ISSN 2078-7170.

The spontaneous dissection of a coronary artery during pregnancy is a rare cause of acute myocardial infarction, with a high risk of maternal death. It can be diagnosed through coronary angiography, although many cases are diagnosed during autopsy. There is presented the case of a 38-year-old white woman, smoker, multiparous, that at the fifth day postpartum presented midthoracic, oppressive and intense pain, and the electrocardiogram evidenced an extensive acute anterior myocardial infarction. The coronary angiography showed dissection of the left coronary artery including the left main, the left anterior descending and the circumflex artery. A primary angioplasty was performed and there was a hyperacute thrombosis of the implanted stent. The patient died on the fifth day in refractory cardiogenic shock. There are no standard treatment recommendations, the primary angioplasty is considered the treatment of choice. The multidisciplinary integration of cardiologist, obstetrician, cardiac surgeon and anesthesiologist is essential to decide the best treatment.

Palavras-chave : Myocardial infarction; Coronary artery dissection; Puerperium; Percutaneous coronary intervention.

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