A Postpartum Case of Non-ST Elevation Myocardial Infarction Due to Coronary Artery Aneurysm After Preeclampsia.

Acute coronary syndrome (ACS) in the postpartum period is a rare but serious complication, particularly in patients with a recent history of preeclampsia. Preeclampsia is a multifactorial disorder characterized by hypertension, proteinuria, and peripheral edema due to abnormal placentation and vascular remodeling. We present the case of a 21-year-old healthy female patient with no history of cardiovascular disease (CVD), one week postpartum after cesarean delivery for severe preeclampsia, who developed a non-ST elevation myocardial infarction (NSTEMI). Cardiac catheterization revealed a left anterior descending (LAD) artery aneurysm with 99% stenosis, necessitating urgent stenting. Despite the rarity, the aneurysm was suspected to be secondary to preeclampsia-related endothelial dysfunction. The patient was managed with dual antiplatelet therapy, heparin, and blood pressure control. After stabilization and discharge, she maintained regular follow-up with her primary care physician to discuss secondary prevention of further cardiovascular adverse events. Postpartum ACS, especially secondary to coronary artery aneurysm (CAA), is exceedingly rare but highlights the importance of cardiovascular monitoring in patients with a history of preeclampsia. This case underscores the need for further research into endothelial dysfunction and thrombogenicity in preeclampsia to improve screening, prevention, and management strategies.