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

From: Spontaneous dissection of the coronary and vertebral arteries post-partum: case report and review of the literature

Case ID Presentation Imaging Treatment/ Follow-up
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
  1. STEMI, ST elevation myocardial infarction; EF, ejection fraction; LAD, left anterior descending coronary artery; LCx, left circumflex coronary artery; OM2, second obtuse marginal branch; OM1, first obtuse marginal branch; CABG, coronary artery bypass graft; CT, computed tomography; LIMA, left internal mammary artery.