{
    "abstract": "Pregnancy-associated spontaneous coronary artery dissection (SCAD) and reversible cerebral vasoconstriction syndrome (RCVS) are rare conditions that may occur during pregnancy and the postpartum period. The coexistence of both diseases may pose a risk to patients, potentially resulting in a variety of complications and clinical manifestations. This is considered the first case of a patient who successfully recovered from a critical condition in the postpartum period, with contemporaneous SCAD and RCVS.\nA 33-year-old female with no known medical history was referred to the emergency department after experiencing cardiac arrest, which occurred 1 week after giving birth to her third child. She complained of sudden anterior squeezing chest pain, accompanied by a headache, and eventually collapsed due to ventricular fibrillation with seizure. She was successfully resuscitated after receiving basic life support. She showed an alert mentality and did not experience any further seizure events or additional neurological symptoms. Although vital sign remained stable, the level of highly sensitive troponin I was significantly elevated. Electrocardiography revealed sinus rhythm with T-wave inversion at V1-4, while chest computed tomography (CT) demonstrated severe aspiration pneumonia. The patient was admitted to the intensive care unit due to a high requirement of O2 supply. A consultation with the neurologic department and a brain magnetic resonance angiography (MRA) were conducted for the thunderclap headache. The brain MRA demonstrated stenosis in the basilar artery, the right M2 segment, and bilateral A1 segments, along with sulcal hyperintensity on post-contrast fluid-attenuated inversion recovery (FLAIR) suggesting blood-brain barrier breakdown due to vasoconstriction. Formal echocardiography showed regional wall motion abnormality in the left anterior descending artery (LAD) territory. After the improvement of pneumonia, a coronary angiography was performed, revealing diffuse luminal narrowing from the mid to distal LAD due to a long segmental, extensive dissection. We decided to maintain the medical therapy. A follow-up coronary CT angiography performed 6\u00a0months later revealed complete remission of the dissected coronary vessel, and a brain MRA checked 3\u00a0months later showed resolved vasoconstriction of the relevant cerebral vessels.\nThe physicians must be aware of pregnancy-associated complications in certain patients. Clear diagnoses and proper treatments are required in pregnant patients who may be exposed to multiple acute conditions, in order to reduce complications and achieve favorable outcomes.",
    "authors": [
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea.",
            "firstname": "Sang Gon",
            "initials": "SG",
            "lastname": "Yoon"
        },
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea. yjsong421@naver.com.",
            "firstname": "Yeo-Jeong",
            "initials": "YJ",
            "lastname": "Song"
        },
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea.",
            "firstname": "Yun-Seok",
            "initials": "YS",
            "lastname": "Song"
        },
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea.",
            "firstname": "Jino",
            "initials": "J",
            "lastname": "Park"
        },
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea.",
            "firstname": "Seunghwan",
            "initials": "S",
            "lastname": "Kim"
        },
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea.",
            "firstname": "Dong-Kie",
            "initials": "DK",
            "lastname": "Kim"
        },
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea.",
            "firstname": "Ki-Hun",
            "initials": "KH",
            "lastname": "Kim"
        },
        {
            "affiliation": "Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 48108, Korea.",
            "firstname": "Doo-Il",
            "initials": "DI",
            "lastname": "Kim"
        },
        {
            "affiliation": "Division of Pulmonology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.",
            "firstname": "Hyun Kuk",
            "initials": "HK",
            "lastname": "Kim"
        },
        {
            "affiliation": "Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.",
            "firstname": "Dong Ah",
            "initials": "DA",
            "lastname": "Lee"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s43044-024-00464-8\n10.5811/cpcem.2019.4.41305\n10.1177/1358863X145679\n10.1136/hrt.2004.038869\n10.1055/s-0041-1735923\n10.1016/j.jccase.2021.06.014\n10.1016/j.jcin.2020.09.036\n10.1186/s10194-017-0738-x\n10.4103/1995-705X.105737\n10.1016/j.jacc.2017.05.055\n10.1016/j.jacc.2017.06.053\n10.1186/s41983-023-00607-9\n10.3348/jksr.2013.69.5.343\n10.3390/neurolint14020040\n10.1007/s00415-020-10193-y\n10.1111/imj.12669\n10.1016/S0008-6363(01)00473-4\n10.1016/S0008-6363(01)00473-4\n10.12659/AJCR.938322\n10.14503/THIJ-17-6403\n10.1177/0333102414547139\n10.3174/ajnr.A7212\n10.1001/jamacardio.2021.4690",
    "journal": "The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology",
    "keywords": [
        "Case report",
        "Postpartum",
        "Pregnancy",
        "Reversible cerebral vasoconstriction syndrome",
        "Spontaneous coronary artery dissection"
    ],
    "methods": null,
    "publication_date": "2024-03-19",
    "pubmed_id": "38498256\n31404313\n25835347\n15310722\n34790334\n35079302\n33248982\n28229321\n23439852\n19492033\n28728686\n28838364\n36647436\n35736621\n32894331\n25511128\n34879501\n11861030\n36774532\n31236082\n25164918\n34167957\n34817541",
    "results": null,
    "title": "Concurrent spontaneous coronary dissection and reversible cerebral vasoconstriction syndrome during postnatal care.",
    "xml": "<Element 'PubmedArticle' at 0x7885069c5f80>"
}