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Ann Thorac Surg 2001;71:1025-1027
© 2001 The Society of Thoracic Surgeons

Case report

Postpartum coronary artery dissection complicated by heparin-induced thrombocytopenia and thrombosis

Charles S. Eby, MDa, Lawrence R. McBride, MDb

a Department of Pathology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
b Department of Surgery/Thoracic Division, Saint Louis University School of Medicine, St. Louis, Missouri, USA

Accepted for publication September 6, 2000.

Address reprint requests to Dr Eby, Department of Pathology and Immunology, Division of Laboratory Medicine, Washington University School of Medicine, Campus Box 8118, 660 S Euclid Ave, St. Louis, MO 63110-1093
e-mail: eby{at}labmed.wustl.edu

A 32-year-old woman presented with an acute anterior-lateral myocardial infarction 7 days postpartum. Coronary angiography revealed an occlusive left main coronary artery dissection. After coronary artery bypass surgery the patient’s cardiac function improved and stabilized. Thrombocytopenia and a femoral artery thrombosis after 9 days of heparin exposure marked the development of heparin-induced thrombocytopenia and thrombosis that was successfully managed with argatroban, a direct thrombin inhibitor anticoagulant.






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