Institute of Forensic Medicine, Pusan National University School of Medicine, Korea. gyhuh@pusan.ac.kr

Spontaneous coronary artery dissection (SCAD) is a rare disease that occurs most commonly in young people, especially in peripartum or postpartum women without traditional risk factors for coronary artery disease. We describe the case of a 30-year-old woman who suddenly died approximately 2 weeks postpartum period. She was otherwise healthy with no cardiac risk factors. On autopsy, the coronary artery showed 4cm long segment of dissection, starting from the left main artery to anterior descending branch. Microscopic finding of the dissection revealed a tear between tunica media and adventitia, creating an intramural hematoma. The left ventricle showed multifocal areas of acute myocardial infarction with reperfusion injury. SCAD should be considered in the differential diagnosis of any young person sustaining an acute myocardial infarction, especially women in the postpartum state.

Key Word: Spontaneous coronary artery dissection, early postpartum period