Coronary Artery Dissection in Pregnancy or Lactation (Breastfeeding)
Managing coronary artery dissection in a female patient who is pregnant or breastfeeding requires specific clinical considerations that differ from the standard approach — both in the acute interventional phase and in subsequent care.
Clinical Scenario
This protocol applies to female patients presenting with coronary artery dissection during pregnancy or the lactation (breastfeeding) period. Special consideration must be given to pharmacotherapy recommendations in this population, as both the pregnant and lactating states affect how treatment decisions are individualised.
Treatment Approach (partial)
The approach involves coronary evaluation and, where required, revascularisation — the choice of interventional strategy depends on the coronary anatomy and the expertise available at the treating centre.
Full protocol — including decision criteria, sequencing, and individualisation guidance — is available via the link below.
Clinical Goal
Relief of myocardial ischemia.
References
DOI: 10.1161/cir.0000000000000564
Special consideration must be given to post-SCAD pharmacotherapy recommendations for women who are pregnant or lactating.
In such cases, it is the consensus of the working group that urgent intervention with PCI or coronary artery bypass grafting (CABG) should be considered, but such decisions should be individualized and contemplated in the context of the coronary anatomy and the expertise of the operators or centers.
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