Dr. Kholghi presented a classic case of spontaneous coronary artery dissection (SCAD) in a young woman with prior IVF pregnancies who was admitted with chest pain and this EKG:
Code STEMI was activated and the patient was taken for cath, which revealed a dissection of the OM1.
Take Away Points
Consider a diagnosis of SCAD in a young women presenting with chest pain or ACS
Risk factors include postpartum status, multiparity and exposure to hormonal therapy, so this is important historical information to gather
Conservative therapy (rather than revascularization), is the preferred treatment strategy
Below is a link for a related case from NEJM Case Records of the Massachusetts General Hospital (thanks for the recommendation, Dr. Burnett!)