Askandar Sameh, Flatt David, Rosu Daniela, Khouzam Rami N
Baptist Memorial Hospital/Church Health, Department of Family Medicine - Memphis, TN.
University of Tennessee Health Sciences Center, Department of Medicine, Division of Cardiology - Memphis, TN.
J La State Med Soc. 2017 Jul-Aug;169(4):101-105. Epub 2017 Aug 28.
Acute coronary syndrome (ACS) during postpartum period is rare. In the current manuscript we present a case of a postpartum patient who developed ACS attributed to coronary vasospasm in the absence of vasocontrictive medication or smoking. This condition resolved with intracoronary injection of nitroglycerine and verapamil.
A 26-year-old woman, postpartum day five, presented with a sudden onset of chest pain and an acute ST-segment elevation on ECG. Coronary artery catheterization showed multiple areas of spasm, which was relieved by intracoronary injection of nitroglycerine and verapamil. Post-catheterization hospital stay was uneventful and the patient was discharged in a stable condition.
Early diagnosis and treatment of ACS in the peripartum period is crucial. Vasospastic coronary disease should be included in the differential diagnosis of peripartum chest pain. Nitrates are still considered the best treatment option with or without calcium channel blockers for both recurrence and prevention.
产后急性冠状动脉综合征（ACS）较为罕见。在本手稿中，我们介绍了一例产后患者，该患者在未使用血管收缩药物或吸烟的情况下发生了归因于冠状动脉痉挛的ACS。通过冠状动脉内注射硝酸甘油和维拉帕米，这种情况得到了缓解。
一名26岁女性，产后第5天，突发胸痛，心电图显示急性ST段抬高。冠状动脉导管检查显示多个痉挛区域，冠状动脉内注射硝酸甘油和维拉帕米后痉挛缓解。导管检查后住院期间病情平稳，患者出院时情况稳定。
围产期ACS的早期诊断和治疗至关重要。血管痉挛性冠状动脉疾病应纳入围产期胸痛的鉴别诊断。硝酸盐仍然被认为是复发和预防的最佳治疗选择，无论是否联合使用钙通道阻滞剂。
