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Embarazada con disección coronaria espontánea resucitada de manera exitosa: reporte de caso / Pregnant woman with spontaneous coronary dissection successfully resurrected: case report
Resumen
Resumen
Introducción: la disección coronaria espontánea consiste en la disrupción de la pared arterial, con manifestaciones clínicas que van desde la angina inestable hasta la muerte súbita cardiaca. Se presenta el caso de una paciente obstétrica resucitada exitosamente tras una disección coronaria espontánea.
Caso clínico: mujer de 37 años con embarazo de 33 semanas y antecedente de preeclampsia en el embarazo anterior, quien consultó por dolor torácico de 30 minutos. Posterior a su ingreso presentó pérdida de la consciencia y paro cardiorrespiratorio. Se realizaron maniobras básicas y avanzadas de resucitación, y se trasladó a la unidad de cuidados intensivos donde se diagnosticó disección de arteria coronaria derecha. A los 14 días se dio alta hospitalaria, sin secuelas neurológicas.
Conclusiones: la disección coronaria espontánea en la paciente obstétrica corresponde a una urgencia médica, en la cual deben implementarse medidas farmacológicas y quirúrgicas tempranamente con el fin de promover el bienestar del binomio madre-feto.
Abstract
Background: Spontaneous coronary dissection is a disruption of the arterial wall, with clinical manifestations ranging from unstable angina to sudden cardiac death. It is presented a case of an obstetric patient who is successfully resuscitated after a spontaneous coronary dissection.
Clinical case: 37-year-old female patient with a 33-week pregnancy and a history of preeclampsia in the previous pregnancy. She consulted for a 30-min chest pain. After her admission, the patient presented loss of consciousness and cardiorespiratory arrest. Basic and advanced life supports were given and then she was transferred to the intensive care unit where a dissection of the right coronary artery was diagnosed. After 14 days, the patient was discharged from the hospital without neurological sequelae.
Conclusions: Spontaneous coronary dissection in the obstetric patient corresponds to a medical emergency, in which pharmacological and surgical measures must be implemented early in order to promote the fetal maternal well-being.
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DOI: https://doi.org/10.24875/RMIMSS.M21000057
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