Pregnancy-associated coronary artery dissection (P-SCAD): A crucial differential diagnosis for chest pain during pregnancy

Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) is a rare but severe cause of acute coronary syndrome. The clinical presentation of P-SCAD can vary widely, ranging from asymptomatic cases to cardiac arrest and sudden cardiac death. Chest pain is the most common presenting symptom, though other symptoms, such as dyspnea, nausea, vomiting, and palpitations, may also occur. P-SCAD is often underdiagnosed because patients typically do not fit the profile of those with atherosclerosis and myocardial infarction. It predominantly occurs in younger individuals without traditional cardiovascular risk factors. The diagnosis of P-SCAD is commonly made during coronary angiography. Therefore, in pregnant and postpartum females presenting with chest pain or pressure, P-SCAD should be considered in the differential diagnosis, regardless of the presence of other risk factors such as age, hypertension, or diabetes.