Pregnancy associated spontaneous coronary artery dissection.

Spontaneous coronary artery dissection is an unusual cause of acute coronary syndrome, most commonly seen in the peripartum patient with no overt cardiovascular risk factors. Hormonal and hemodynamic changes play a role in the pathogenesis. Early management is known to improve the survival rate. We report the case of a 27 year old healthy pregnant woman (24 weeks) presenting with respiratory distress, chest pain and late decelerations. She had an emergency caesarean section due to fetal decelerations and was subsequently diagnosed with a left main dissection on angiography. Management included conservative measures followed by coronary artery bypass graft.