Case report
Intraoperative Diagnosis of Aortic Dissection in Pregnancy

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Case Report

A 34-year-old, G4P2, 158-cm tall, 82-kg woman at 37 weeks gestation presented with complaints of acute chest pain and mild shortness of breath. She had no significant past medical history and had 2 previous uneventful pregnancies. At an outside facility, she was diagnosed with acute MI based on an electrocardiogram (ECG) showing anterior and anterior-septal myocardial ischemia and a serum troponin of 0.79 ng/mL (normal <0.1). She was transferred to the authors' institution for tertiary care. On

Discussion

A highly unusual presentation of an acute aortic dissection in a young pregnant patient without any predisposing risk factors is reported. Although the patient was initially diagnosed with primary acute coronary syndrome, intraoperative echocardio-graphy was critical in correctly defining the etiology of MI as a type-A dissection, prompting a change in the management of the patient. Fetal distress likely occurred because of the hypotension and low cardiac output from worsening acute heart

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A.M. was supported by intramural departmental funds and by grants from NIH/NHLBIP01 HL078931 and NIHRO1-HL084261.

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