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Among the general population, spontaneous coronary artery dissection (SCAD) is a very uncommon cause of myocardial infarction. However, among the pregnant population, SCAD is the cause of greater than 40% of myocardial infarctions 1 . It typically affects young women who do not have any of the common risk factors for atherosclerosis 2 . The most common presenting symptom is chest pain, often associated with diaphoresis, nausea and dyspnea. In the Mayo clinic SCAD registry, 49% of patients presented with ST elevation myocardial infarction (STEMI), 44% presented with non-ST elevation myocardial infarction (NSTEMI) and 7% presented with unstable angina 3 . Among pregnant women, the most common time for presentation was in the late third trimester, intrapartum or postpartum 4 .

Mode of Delivery for a Term Patient with Spontaneous Coronary Artery Dissection