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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
Thu Jan 29 2026
Journal Name
Al–bahith Al–a'alami
Online Newspapers in the Age of the Web 2.0
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If we go beyond the technical aspects of the Web 2.0, and we focus specifically on its interactive characteristics, we may say it represents not only a fundamental shift in the structure of the press institutions and its practices but also a shift in the relationships that existed, previously, between the press and the audience. Web 2.0 has enabled the newspapers to renovate their representations and practices of the profession and opens to the new horizons either in terms of readership or advertising revenues. Parallel to that it also has empowered the user to transcend the passivity he has always been confined in and has become a more active participant in the creation and generation of media contents even though this practice is somew

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Publication Date
Sun Apr 17 2016
Journal Name
Al-academy
Stability and periphery in Graphic design: دينا محمد عناد
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Graphic design art depends on changeable cognitive systems which their relation and items relying on the accumulation of humane knowledge and thong and the humane look to the venality and his explanation to the relation between him and the venality , then the graphic design art becomes an important item of this accumulation knowledge besides , it is on kind of knowledge kinds . The technological advancement in communication lauds to increasing in communication media and design methods , where the computer and its application in graphic design promotes the design process because of it's capalebities which lead to in creasing in production process , minimizing the cost and time and achieving creative and aesthetic aspect because of it's fe

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
Aesthetic discourse in the significance of commercial advertisement designs
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The current research is concerned with the study of (aesthetic discourse in the significance of commercial advertisement designs), according to a knowledge structure defined by function and creativity, and the main goal is to interpret the reality of forms, their various sources, their essence, meanings, formal relationships, and design ideas in order to achieve the visual goal as a typographic achievement. It arises through the designer’s internal mental intuition to produce shapes based on subjective feelings that refer his preconceptions about those shapes with his feelings to creative formations. Aesthetic discourse is produced from the mind depending on the various symbolic, psychological and social functions, production methods,

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
The cartographic representation of vertical home in Baghdad government
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The cartographic representation of geographical phenomenon considers the essential base in geographical analysis since as it supports the vertical house which is apartment houses consist of apartments which represent civil phenomenon , the aim of this study is to project the rule of cartographic representation methods in geographical analysis and make comparison in economic and social aspects for two approaches , the vertical and construction building methods.
The expand of city horizontally represent a problem in itself because it leads to loss of civil lands and overpass the agricultural lands as a result ,the ratio of habitation of land usage is so large in comparison with another usages of lands of the cities ; therefore ; many co

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Publication Date
Sat Mar 01 2008
Journal Name
Iraqi Journal Of Physics
Investigation of Electromagnetically Induced Transparency in the Rubidium Vapor
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We have studied theoretically the response of atomic three- level cascade scheme
of rubidium vapor to a strong laser under conditions in which electromagnetically
induced transparency would be induced on a weak probe beam. We show that the
medium that is an opaque to a probe laser can, by applying both lasers
simultaneously, be made transparent.

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Publication Date
Fri Sep 20 2013
Journal Name
World Journal Of Experimental Biosciences (issn: 2313-3937)
T-Lymphocytes Subsets in inactive carrier state of HBV
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This study included nine patients with inactive carrier states of HBV and 14 healthy control groups. The number and the percentage of T-lymphocyte (CD3+ Cells) in the peripheral blood of these groups showed no significant difference. Similar trend was observed when number and percentages of T helper cells (CD4+ cells) and T cytotoxic lymphocytes (CD8+ cells). Moreover, no significant difference in CD4+ /CD8+ cells ratio (P > 0.05) in peripheral blood of patients with inactive carrier state of HBV as compared with healthy control group. The levels of total serum bilirubin (TSB) concentration and alanine aminotransferase (ALT) activity were similar to control group. The levels of immunoglobulin concentration (IgG and IgM) in patients g

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Limping in twenty years old male A Case Report
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Background: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date.Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magne

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Publication Date
Thu Jan 10 2019
Journal Name
Journal Of The College Of Education For Women
Types of parallelism in the poetry of Mahmoud Darwish
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This research deals with the study of types of parallelism in contemporary Arabic poetry and took the hair Mahmoud Darwish, a model for the study has been the goal of research to clarify the term parallelism and the statement of the most important types, said evidence of that in the poetry of Mahmoud Darwish

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Publication Date
Sat Jan 01 2022
Journal Name
Geotechnical Engineering And Sustainable Construction
Regulation of Supplier Standards in Iraq: Through Sustainability Standards
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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Philosophical Framework To Intellectual Capital Readiness in Iraqi Organizations
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           This research aim to present theoretical and philosophical framework regards topic of intellectual capital readiness in Iraqi universities. That is, by using strategic map in balanced score card of Norton and Kaplan (2004). This research discusses theoretical content for three main aspects reflect in its nature elements of intellectual capital readiness in organizations. This includes human capital readiness, information capital readiness and organizational capital readiness. To clear each element, the authors relay on mechanism to determine gape per element of intellectual capital elements.

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