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J Invasive Cardiol. 2006 Mar;18(3):E117-20.

Spontaneous dissection of the left coronary tree after an interruption of pregnancy treated with extensive stenting.

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Department of Cardiology, Ospedale Mauriziano Umberto I, Torino, Italy.


We report a case of a healthy 23-year-old woman who presented with cardiogenic shock due to an extensive spontaneous coronary dissection that caused distal subocclusion of the left main and left circumflex artery with occlusion of left anterior descending artery. This spontaneous coronary dissection occurred during oral contraceptive therapy after a recent interruption of pregnancy. The patient was successfully treated with extensive primary stenting of the left coronary tree. Interruption of pregnancy followed by oral contraception should be added to the list of clinical conditions associated with spontaneous coronary artery dissection. The risk of coronary dissection may extend beyond the trigger event because of some not yet well-known alterations in the connective tissue of these patients. An interventional procedure, possibly with stenting, should be considered the first therapeutic option in patients with suitable anatomy.

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