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CASE REPORT
Spontaneous coronary artery dissection in a postpartum e-cigarette smoker
  1. Navid Ahmed1,
  2. Aleksandr Kalininskiy1,
  3. Himali Gandhi1,
  4. Jooyoung Julia Shin2
  1. 1Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
  2. 2Division of Cardiology, Albert Einstein College of Medicine, Bronx, New York, USA
  1. Correspondence to Dr Navid Ahmed, nahmed{at}montefiore.org

Summary

Spontaneous coronary artery dissection (SCAD) is a rare but lethal cause of acute coronary syndrome that occurs in young women during the peripartum/postpartum periods. We present a case of a 41-year-old woman with no significant medical history, but was a habitual e-cigarette smoker who presented with atypical chest pain 2 weeks after an uncomplicated delivery while breast feeding. The patient was found to have elevated cardiac enzymes and ST segment elevations in the anterior leads. An urgent cardiac catheterisation was performed, which revealed dissection and occlusion of the left anterior descending artery, and a drug-eluting stent was placed that resulted in the resolution of chest pain. Physiological changes during the postpartum period may be linked to an increased risk of developing SCAD.1 In addition, e-cigarette smoking is associated with increased oxidative stress and sympathetic activity, which may predispose patients to an increased risk of acute coronary syndrome.

  • cardiovascular medicine
  • interventional cardiology
  • obstetrics and gynaecology
  • pregnancy
  • reproductive medicine

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Footnotes

  • Contributors NA, AK and JJS were involved in the care of the patient and thus contributed to the planning of the manuscript, drafting and editing of the manuscript, and framing of the teaching points. HG was also involved in drafting and editing portions of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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