Postpartum Spontaneous Coronary Artery Dissection An Uncommon Cause of Acute Coronary Syndrome.

Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) that tends to affect young females. Diagnosis is confirmed by a dissection flap that is seen on coronary angiogram in the absence of underlying coronary atherosclerosis. New techniques in intra-coronary imaging such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are useful in diagnosing SCAD. These techniques are helpful because SCAD is often associated with intra-mural hematoma within the vessel wall that would not be visualized on coronary angiography. Given the lack of randomized trials, most data on treatment of this relatively uncommon condition is controversial and based on expert opinion. Postpartum SCAD comprises a small subgroup of all patients presenting with SCAD.