A Rarer Case of Spontaneous Coronary Artery Dissection causing Acute Coronary Syndrome in a Puerperal Woman: Case Report

Chest pain is one of the most common complaints of patients presenting to the emergency room department. There are many causes of chest pain and providers must always consider acute coronary syndrome (ACS). Spontaneous coronary artery dissection is a very rare cause of ACS but providers must consider this possibility in younger patients without risk factors or a history of coronary artery disease. This rare phenomenon is commonly associated with pregnant women or those in the postpartum period. This is a case report study describing a classic scenario of a postpartum female in her early 30s who presented with spontaneous coronary artery dissection. Providers obtained the usual tests of an electrocardiogram (EKG) and blood work. She then had a heart catheterization performed. The patient was conservatively managed through use of medications without any use of invasive measures. The patient also had other images of the chest taken to rule out other causes of chest pain such as pneumothorax and pulmonary embolism. There were EKG changes noted, as well elevated troponin levels suggestive of heart damage. The heart catheterization results showed coronary artery dissection involving the artery that correlated with the EKG changes. Spontaneous coronary artery dissection is a rare phenomenon that can present as ACS. Pregnant and postpartum women are at higher risk to develop this condition. It is essential to consider this condition along with other causes of chest pain.