2026 SOAP Annual Meeting

Slide 1 - Background

-Pregnancy associated spontaneous coronary artery dissection (P-SCAD) is the leading cause of myocardial infarction in pregnancy1

-Pathophysiology shown here

Slide 2 - Case Report

Initial presentation:

-30 yo G4P0 at 36w2d with acute chest pain

-ECG showed inferior T wave inversions

-Troponin peak = 651 ng/L

-Coronary CT angiography shown here

-Patient discharged home on labetalol

-Multidisciplinary discussion for cesarean delivery

Intraoperative Management

-Goals: HR control, BP narrow range

-2x 18g PIV, preinduction arterial line

-DPE with slow incremental dosing

Post op

-Monitored 24hrs with art line

-Discharged on beta-blockade

Slide 3 - Discussion

-Dangers of P-SCAD2

-Vaginal vs. Cesarean delivery3

-Intraoperative anesthetic goals; monitoring and slow neuraxial titration4,5

-Importance of multidisciplinary meetings

Anesthetic Management of Scheduled Cesarean Delivery in a Patient With Pregnancy-Associated Spontaneous Coronary Artery Dissection