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Spontaneous Coronary Artery Dissection in Multiple Gestation Peripartum Period
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Background: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall. SCAD is a highly uncommon cause of myocardial infarction (0.1 to 0.4 %).

Case presentation: 40-year-old African American woman, G1T1P0A0L2, with a past medical history of tobacco abuse and obesity who had uncomplicated cesarean section delivery for healthy twins two weeks prior presented with substernal, sudden onset chest pain. The pain radiated to left arm and back, pressure-like, and is associated with nausea, vomiting, and dyspnea.

On examination she was within normal limits except for a well-healed C-section wound. An electrocardiogram showed normal sinus rhythm with Nonspecific ST Abnormality. The first set of troponins less than 0.03, the second set shows troponins 0.18 and D-dimer 2340. The chest x-ray was unremarkable. An echocardiogram showed only mild to moderate mitral valve regurgitation. CT angiography of the chest showed no evidence of pulmonary embolism. She was started on a heparin drip and catheterization the next day showed no atherosclerotic coronary artery disease, but SCAD of inferior diagonal first branch noted. No intervention was done, heparin was stopped. The patient was started on aspirin, statin, Clopidogrel, Metoprolol, and Lisinopril per cardiology recommendation.

Conclusions: As an internist and primary care provider, we should keep Non-atherosclerotic SCAD in mind when a young female patient presents with acute chest pain. More studies are needed to find out the optimal management.

Current recommended conservative medical management includes long-term aspirin, beta blocker, and one year of clopidogrel, with the addition of a statin in patients with dyslipidemia.

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Publication Date
Sun Dec 07 2025
Journal Name
Al-fatih Journal
The impact of the use of some herbal sedative level of achievement in the development of air pistolEmpirical researchOn a sample of players Faculty of Physical Education for Girls
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تعد الرماية واحدة من الألعاب التي يقاس مستوى الانجاز فيها بالأرقام إذ ارتفعت الأرقام المسجلة بالنسبة لسلاح المسدس الهوائي حتى وصلت عند بعض الأبطال العالميين إلى الانجاز النهائي ، وقد لجأ المدربون إلى مختلف الطرق التدريبية, وان ضعف الثبات والتركيز هما اللذان يقودان إلى هبوط مستوى الانجاز في الرماية ، ولتحقيق التركيز والثبات المطلوبين أثناء الرمي يجب التدريب على مطاولة حمل السلاح التي تعد من أصعب تدريبات الر

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Publication Date
Tue Feb 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Return Variation on Investment as a Function for the Difference of Market Share: An Applied Research on a Sample of Private Banks listed in Iraq Stock Exchange (ISX)
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    The research specified with study the relation  between the market share for the sample research banks and the amount of the achieved revenues from the investment, where the  dominated belief  that there potentiality enhancing the revenue on investment with the increase of the banks shares in their markets after their success in achieving rates of successive growth in their sales of sales and to a suitable achieve  market coverage for their products and they have dissemination and suitable  promotion activity, the  market share represented the competition  for the banks, and the markets pay attention to the  market share as a strategic objective and to maintain them also increasi

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Publication Date
Wed Sep 20 2006
Journal Name
00
INVESTIGATING SOME OF THE SYNTACTIC ERRORS MADE BY EFL COLLEGE STUDENTS IN WRITTEN ENGLISH EXPRESSIONS استقصاء بعض الاخطاء النحوية لطلبة الكلية دارسي اللغة الانكليزية لغة اجنبية في التعابير الانشائية
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Publication Date
Tue Jan 01 2019
Journal Name
Mustansiriyah Journal Of Sports Science
The use of training methods in accordance with special exercises to develop flexibility and perform the skills of shooting from above the chest (abduction) to wrestlers ages (14-15)"
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Evolution has become a feature of this era because of the speed that makes it open multiple horizons and many to identify everything that is new in different areas and also characterized by the competitive position of emotional attitudes changing depending on the positions of winning and defeat, and the use of training methods are the most important pillars of the game of wrestling, The methods contribute to raising the level of the wrestler and refining his physical and skill potential. The problem of the research is that the shooting exercises from above the chest are very important in Roman wrestling and can be terminated by the player. Through very personal interviews for coaches and concluded that there is a weakness in the level of fl

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
Find the concentration of radon gas emitted naturally from the bones and skin of some kinds of birds and local and imported chicken available in the City of Baghdad
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In the present research we the study the deposition of radioactive elements naturally and particularly radioactive radon gas in parts of the body of organisms which are of direct relevance to human life in the city of Baghdad as the samples which were collected from the bones and skin of some kinds of birds and chicken based on the principle that radioactive elements are concentrated always on the bones. We use of this as the exercise detector impact nuclear (CR-39), using the technology Cylindrical diffusion , the results indicated that the largest concentration of radon found in the bone bird Seagull tapered as it was (625 ± 37) Bq.cm-3, and less concentration of radon gas in the chicken bones of Al-kafeel as it was (105 ± 10) Bq.c

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Publication Date
Sun Jun 30 2024
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
The impact of flexibility in the design of educational interior spaces (University of Baghdad Studio as a model) (أثر المرونة في تصميم الفضاءات الداخلية التعليمية (مراسم جامعة بغداد أنموذجا
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Publication Date
Fri Nov 20 2015
Journal Name
Iraqi Journal Of Science
New Approach for Determination of Oxonium Ion in Inorganic Acids by Quenched Fluorescence of Analytically Interested Species via the Liberated Bromine Using Continuous Flow Injection Laser Diode Fluorimeter Analyser
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A new method is characterized by simplicity, accuracy and speed for determination of Oxonuim ion in ionisable inorganic acid such as hydrochloric (0.1 - 10) ,Sulphuric ( 0.1 - 6 ),nitric ( 0.1 - 10 ), perchloric ( 0.1 - 7 ), acetic (0.1 - 100 ) and phosphoric ( 0.1 - 30 ) ( mMol.L-1 )acids. By continuous flow injection analysis. The proposed method was based on generation of bromine from the Bro-3-Br-- H3O+. Bromine reacts with fluorescein to quenches the fluorescence . A sample volume no.1 (31μl) and no.2 (35μl) were used with flow rate of 0.95 mL.min-1 using H2O line no.1as carrier stream and 1.3 mL.min-1 using fluorescein sodium salt line no.2. Linear regression of the concentration ( mMol.L-1 ) Vs quenched fluorescence gives a correla

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Publication Date
Mon Jan 02 2023
Journal Name
Pakistan Heart Jornal
The Effect of the Strategy of Differentiated Education According to the Auditory Learning Style by Using Assistance in Learning the Back Kick (T-Chagi) for the Young Players of …
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Publication Date
Thu Dec 29 2022
Journal Name
Journal Of The College Of Languages (jcl)
The morphological structure of nouns and verbs in the novel "Astonishment" by the novelist Aharon Applefield, Morphological study.: מבנה שמות עצם והפעלים ברומן תימהון לסופר אהרון אפלפלד עיון מורפולוגי
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This research sheds light on the morphological structure of nouns and verbs in the novel "ASTONISHMENT" by the novelist Aharon Applefield by analysing selected models from the novel in a morphological analysis in order to identify the most important morphological features of this structure according to a statistical analytical approach.

 The morphological structure is the main pillar of the linguistic structure of the literary text. Morphology is the science that studies the word, by which its structure and original letters are known, and the change that has occurred to it.  The aesthetics of the fictional text is reflected in this structure, through which the writer conveys his ideas and narrations to the reader.  The research

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Publication Date
Wed Nov 14 2018
Journal Name
Journal Of Engineering And Applied Sciences
DEMONSTRATE OF MAGNETIC FIELD EFFECT ON THE CAPABILITY OF ADSORPTION PROCESS IN THE REMOVAL OF AZO DYE FROM THE AQUEOUS SOLUTIONS ON CALCINED IRAQI BENTONITE CLAY MINERAL VIA COLUM
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