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Heart attacks during pregnancy or shortly after are rare. When they do happen, a common cause is spontaneous coronary artery dissection. In fact, spontaneous coronary artery dissection is the most common cause of pregnancy-associated heart attack.
Heart attacks typically are caused by a plaque blocking blood from reaching the heart muscle. Spontaneous coronary artery dissection can cause a heart attack, but does it differently and affects mostly women who may not have the common heart attack risk factors. As a result, in many women with spontaneous coronary artery dissection the condition was unrecognized.
Spontaneous coronary artery dissection is a tear in the layers of an artery’s wall. Blood flows under the tear, often making it larger, and pools there. As the area fills with blood, it expands and blocks blood flow.
The cause of spontaneous coronary artery dissection isn’t clear. Researchers suspect the cause is more likely related to hormonal changes after delivery affecting the vascular walls. Indeed, these heart attacks appear to happen more often in the first month after delivery.
Providing Specialized Care for a Woman’s Heart
At the Norton Heart & Vascular Institute Women’s Heart Program, our board-certified and fellowship-trained cardio-obstetrics specialists focus on heart conditions that are more prevalent among women, especially around pregnancy and menopause. Our physicians are at the forefront of research into heart conditions that tend to affect women more than men, and they have the experience and expertise to successfully treat conditions that perhaps have been overlooked in the past.
Women’s Heart Program providers work with your health care team, including your OB/GYN and maternal-fetal medicine specialist, to create a comprehensive care plan.
Common risk factors for heart attack don’t apply to spontaneous coronary artery dissection. Some people with the condition might dismiss symptoms since they don’t think they are at risk. New mothers often are focused on the health of their newborn and may put off addressing symptoms of heart attack.
Spontaneous coronary artery dissection affects women more than men, especially women around menopausal age. Young women in particular with no risk factors for common heart attack, but having symptoms like chest pain, may be evaluated for this disease.
Intense emotional stress, heavy lifting or straining, labor and delivery, and use of hormone-containing drugs or therapies, have been reported to cause spontaneous coronary artery dissection.
If you have chest pain or think you’re having a heart attack, call 911. Don’t attempt to drive yourself to an emergency room.
Symptoms are similar to heart attacks in general and can include:
Reviewed by Li Zhou, M.D.
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