Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management Considerations
Marian Hrebenyk,1 Roman Komorovsky,2 Diana Zhehestovska,1 Lidiya Oryshchyn,3 Oksana Kotsyuba,1 Liliia Zelenenka1 1Department of Therapeutics and Family Medicine, Faculty of Postgraduate Education, Ivan Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 2Department of Internal Medi...
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Dove Medical Press
2025-07-01
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| Series: | International Journal of Women's Health |
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| author | Hrebenyk M Komorovsky R Zhehestovska D Oryshchyn L Kotsyuba O Zelenenka L |
| author_facet | Hrebenyk M Komorovsky R Zhehestovska D Oryshchyn L Kotsyuba O Zelenenka L |
| author_sort | Hrebenyk M |
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| description | Marian Hrebenyk,1 Roman Komorovsky,2 Diana Zhehestovska,1 Lidiya Oryshchyn,3 Oksana Kotsyuba,1 Liliia Zelenenka1 1Department of Therapeutics and Family Medicine, Faculty of Postgraduate Education, Ivan Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 2Department of Internal Medicine II, Ivan Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 3Department of Cardiology, Ternopil Community Hospital No. 2, Ternopil, UkraineCorrespondence: Roman Komorovsky, Ivan Horbachevsky Ternopil National Medical University, 1, Maidan Voli, Ternopil, 46001, Ukraine, Email komorovsky@tdmu.edu.uaAbstract: Acute myocardial infarction (AMI) during pregnancy is a rare but life-threatening condition with unique pathophysiological mechanisms and management challenges. We present the case of a 28-year-old woman at 37 weeks of gestation who developed AMI due to spontaneous coronary artery dissection (SCAD). Initially admitted with retrosternal pain and transient electrocardiographic changes, she exhibited a significant rise in troponin levels, prompting a multidisciplinary reassessment. Conservative management was initially pursued, but recurrent chest pain and worsening electrocardiographic findings necessitated urgent coronary angiography. The procedure confirmed a long dissection of the left circumflex artery, successfully treated with percutaneous coronary intervention using a “stent-in-stent” technique. Given the high-risk nature of her pregnancy, anticoagulation therapy was carefully adjusted to minimize peripartum hemorrhagic complications. At 39 weeks, she underwent cesarean delivery of a healthy neonate. Follow-up evaluation one year post-intervention showed overall improvement, with only minor residual sequelae, including mildly reduced left ventricular function and subtle electrocardiographic changes. This case underscores the complexities of diagnosing and managing SCAD-related AMI in pregnancy, emphasizing the need for individualized treatment strategies that balance maternal cardiovascular risks with fetal safety. Given the rarity of SCAD in this population and the limitations of standardized guidelines, accumulating clinical experience is essential to refine management approaches in future cases.Keywords: acute myocardial infarction, spontaneous coronary artery dissection, pregnancy, management |
| format | Article |
| id | doaj-art-0b042d64dd454a358942ab1b4a485bb5 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-07-01 |
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| series | International Journal of Women's Health |
| spelling | doaj-art-0b042d64dd454a358942ab1b4a485bb52025-08-20T03:31:48ZengDove Medical PressInternational Journal of Women's Health1179-14112025-07-01Volume 17Issue 119231932104504Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management ConsiderationsHrebenyk M0Komorovsky R1Zhehestovska D2Oryshchyn L3Kotsyuba O4Zelenenka L5Department of Therapy and Family Medicine, Faculty of Postgraduate EducationDepartment of Internal Medicine IIDepartment of Therapy and Family Medicine, Faculty of Postgraduate EducationDepartment of CardiologyDepartment of Therapy and Family Medicine, Faculty of Postgraduate EducationDepartment of Therapy and Family Medicine, Faculty of Postgraduate EducationMarian Hrebenyk,1 Roman Komorovsky,2 Diana Zhehestovska,1 Lidiya Oryshchyn,3 Oksana Kotsyuba,1 Liliia Zelenenka1 1Department of Therapeutics and Family Medicine, Faculty of Postgraduate Education, Ivan Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 2Department of Internal Medicine II, Ivan Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 3Department of Cardiology, Ternopil Community Hospital No. 2, Ternopil, UkraineCorrespondence: Roman Komorovsky, Ivan Horbachevsky Ternopil National Medical University, 1, Maidan Voli, Ternopil, 46001, Ukraine, Email komorovsky@tdmu.edu.uaAbstract: Acute myocardial infarction (AMI) during pregnancy is a rare but life-threatening condition with unique pathophysiological mechanisms and management challenges. We present the case of a 28-year-old woman at 37 weeks of gestation who developed AMI due to spontaneous coronary artery dissection (SCAD). Initially admitted with retrosternal pain and transient electrocardiographic changes, she exhibited a significant rise in troponin levels, prompting a multidisciplinary reassessment. Conservative management was initially pursued, but recurrent chest pain and worsening electrocardiographic findings necessitated urgent coronary angiography. The procedure confirmed a long dissection of the left circumflex artery, successfully treated with percutaneous coronary intervention using a “stent-in-stent” technique. Given the high-risk nature of her pregnancy, anticoagulation therapy was carefully adjusted to minimize peripartum hemorrhagic complications. At 39 weeks, she underwent cesarean delivery of a healthy neonate. Follow-up evaluation one year post-intervention showed overall improvement, with only minor residual sequelae, including mildly reduced left ventricular function and subtle electrocardiographic changes. This case underscores the complexities of diagnosing and managing SCAD-related AMI in pregnancy, emphasizing the need for individualized treatment strategies that balance maternal cardiovascular risks with fetal safety. Given the rarity of SCAD in this population and the limitations of standardized guidelines, accumulating clinical experience is essential to refine management approaches in future cases.Keywords: acute myocardial infarction, spontaneous coronary artery dissection, pregnancy, managementhttps://www.dovepress.com/acute-myocardial-infarction-due-to-spontaneous-coronary-dissection-in--peer-reviewed-fulltext-article-IJWHacute myocardial infarctionspontaneous coronary artery dissectionpregnancymanagement |
| spellingShingle | Hrebenyk M Komorovsky R Zhehestovska D Oryshchyn L Kotsyuba O Zelenenka L Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management Considerations International Journal of Women's Health acute myocardial infarction spontaneous coronary artery dissection pregnancy management |
| title | Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management Considerations |
| title_full | Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management Considerations |
| title_fullStr | Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management Considerations |
| title_full_unstemmed | Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management Considerations |
| title_short | Acute Myocardial Infarction Due to Spontaneous Coronary Dissection in Pregnancy: A Case Report and Management Considerations |
| title_sort | acute myocardial infarction due to spontaneous coronary dissection in pregnancy a case report and management considerations |
| topic | acute myocardial infarction spontaneous coronary artery dissection pregnancy management |
| url | https://www.dovepress.com/acute-myocardial-infarction-due-to-spontaneous-coronary-dissection-in--peer-reviewed-fulltext-article-IJWH |
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