Table 1 Summary of findings in post-partum spontaneous CAD and VAD cases

Motreff et al. (2010)

33 F G2P2

2 days post partum

● ECHO: LVEF 58%

● PCI with stent of RCA

● ACS 5 days post partum

● Medical management for VAD

● Vertebral artery dissection

Sharma et al. (2010)

28 F G2P2

10 days post partum

● Coronary CT Angiography: soft plaque in the LAD

● CABG involving LIMA to LAD and saphenous vein bypass graft to OM1

● Non-exertional, intermittent, sub-sternal, sharp chest pain, and left arm numbness

● Coronary angiogram: 90% eccentric stenosis in the ostial LAD extending to first septal perforator and dissection of the LCx

● In OR: Healed dissection in LCx and fresh dissection in LAD

● Intermittent bi-frontal headache

● IVUS: dissection flap in LAD with flow only in true lumen and intraluminal filling defect along entire course of LCx through AV groove

● Medical therapy: ASA Metoprolol, Simvastatin, Coumadin x 6 weeks

● EKG STEMI V1-V2

● MRA cervicocephalic vessels: 50% stenosis with a double lumen in mid-cervical left vertebral artery consistent with dissection

● MRA (6 weeks later): healed vertebral artery dissection and clinically free of symptoms

● CK and Troponin elevated

Cenkowski et al. (2012)

35 F G2P2

7 months post partum

● EKG: Inferior STEMI

7 months post partum

● Sudden onset retrosternal chest pain radiating to jaw, nausea, vomiting

● Coronary angiography: distal dissection of OM2

● Coronary artery dissection distal and not amenable to percutaneous repair

8 months post partum

● Transthoracic echo: mild hypokinesis basal inferior wall and EF 50-55%

● Medical therapy: ASA, Clopidogrel, Metoprolol, Ramipril, Simvastatin

● Diplopia, numbness to left arm and face

● CT angiography: 8mm dissection R vertebral artery in its V1 segment

● Medical therapy: Warfarin x 6 months in addition to ASA and Clopidogrel