A 28 year old postpartum woman with right sided chest discomfort: case outcome

doi:10.1136/bmj.332.7542.643

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Girish Dwivedi, registrar in cardiology1,
Sajad Ahmed Hayat, registrar in cardiology1,
Andonis G Violaris, consultant cardiologist1,
Roxy Senior, consultant cardiologist (roxy.senior@virgin.net)1

Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, Middlesex HA1 3UJ

Correspondence to: R Senior

Accepted 25 November 2005

Four weeks ago we described the case of Mrs Patel, a 28 year old postpartum woman with atypical right sided chest pain (18 February BMJ 2006;332: 406. A treadmill exercise test was non-diagnostic but stress echocardiography showed reduced systolic wall thickening (25 February BMJ 2006;332: 471).

Coronary angiography showed she had a critical lesion in the proximal left anterior descending artery with an associated thrombus (fig 1). The circumflex and right coronary artery had plaque disease but no flow limiting …