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van Leenen K, Jouret J, Demeyer P, Vermeir P, Leenknecht D, Van Driessche L, De Cremer L, Masmeijer C, Boyen F, Deprez P, Cox E, Devriendt B, Pardon B. Particulate matter and airborne endotoxin concentration in calf barns and their association with lung consolidation, inflammation, and infection. J Dairy Sci 2021; 104:5932-5947. [PMID: 33612235 DOI: 10.3168/jds.2020-18981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/12/2020] [Indexed: 11/19/2022]
Abstract
Agricultural operations are important sources of organic dust containing particulate matter (PM) and endotoxins, which have possible negative health consequences for both humans and animals. Dust concentrations and composition in calf barns, as well as the potential health effects for these animals, are scarcely documented. The objective of this study was to measure PM fractions and endotoxin concentrations in calf barns and study their associations with lung consolidation, respiratory tract inflammation, and infection in group-housed calves. In this cross-sectional study, samples from 24 dairy farms and 23 beef farms were collected in Belgium from January to April 2017. PM1.0, PM2.5 and PM10 (defined as particulate matter passing through a size-selective inlet with a 50% efficiency cut-off at a 1.0-μm, 2.5-μm, and 10-μm aerodynamic diameter, respectively) were sampled during a 24-h period using a Grimm aerosol spectrometer (Grimm Aerosol Technik Ainring GmbH & Co. KG). Endotoxin concentration was measured in the PM10 fraction. Thoracic ultrasonography was performed and broncho-alveolar lavage fluid was collected for cytology and bacteriology. Average PM concentrations were 16.3 µg/m3 (standard deviation, SD: 17.1; range: 0.20-771), 25.0 µg/m3 (SD: 25.3; range: 0.50-144.9), and 70.3 µg/m3 (SD: 54.5; range: 1.6-251.2) for PM1.0, PM2.5, and PM10, respectively. Mean endotoxin in the PM10 fraction was 4.2 endotoxin units (EU)/µg (SD: 5.50; range: 0.03-30.3). Concentrations in air were 205.7 EU/m3 (SD: 197.5; range: 2.32-901.0). Lung consolidations with a depth of ≥1, ≥3, and ≥6 cm were present in 43.1% (146/339), 27.4% (93/339), and 15.3% (52/339) of the calves, respectively. Exposure to fine (PM1.0) PM fractions was associated with increased odds of lung consolidations of ≥1 cm (odds ratio, OR: 3.3; confidence interval (CI): 1.5-7.1), ≥3 cm (OR: 2.8; CI: 1.2-7.1), and ≥6 cm (OR: 12.3; CI: 1.2-125.0). The odds of having lung consolidations of ≥1 cm (OR: 13.9; CI: 3.4-58.8) and ≥3 cm (OR: 6.7; 1.7-27.0) were higher when endotoxin concentrations in the dust mass exceeded 8.5 EU/µg. Broncho-alveolar lavage fluid neutrophil percentage was positively associated with PM10 concentration, and epithelial cell percentage was negatively associated with this fraction. Concentration of PM2.5 was positively associated with epithelial cell percentage and isolation of Pasteurella multocida. Although concentrations of fine dust are lower in calf barns than in poultry and pig housings, in this study they were associated with pneumonia in calves. Dust control strategies for reducing fine dust fractions in calf barns may benefit human and animal respiratory health.
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Affiliation(s)
- K van Leenen
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - J Jouret
- Belgian Center for Occupational Hygiene, Tramstraat 59, 9052 Zwijnaarde, Belgium
| | - P Demeyer
- Flanders Research Institute for Agriculture, Fisheries and Food (ILVO), Burgemeester van Gansberghelaan 115 Bus1, 9820 Merelbeke, Belgium
| | - P Vermeir
- Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Valentin Vaerwyckweg 1, 9000 Ghent, Belgium
| | - D Leenknecht
- Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Valentin Vaerwyckweg 1, 9000 Ghent, Belgium
| | - L Van Driessche
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - L De Cremer
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - C Masmeijer
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - F Boyen
- Laboratory for Veterinary Bacteriology, Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - P Deprez
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - E Cox
- Laboratory for Immunology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - B Devriendt
- Laboratory for Immunology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - B Pardon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Gille L, Callens J, Supré K, Boyen F, Haesebrouck F, Van Driessche L, van Leenen K, Deprez P, Pardon B. Use of a breeding bull and absence of a calving pen as risk factors for the presence of Mycoplasma bovis in dairy herds. J Dairy Sci 2018; 101:8284-8290. [DOI: 10.3168/jds.2018-14940] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/26/2018] [Indexed: 11/19/2022]
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Gille L, Boyen F, Van Driessche L, Valgaeren B, Haesebrouck F, Deprez P, Pardon B. Short communication: Effect of freezer storage time and thawing method on the recovery of Mycoplasma bovis from bovine colostrum. J Dairy Sci 2017; 101:609-613. [PMID: 29102148 DOI: 10.3168/jds.2017-13130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/29/2017] [Indexed: 11/19/2022]
Abstract
Mycoplasma bovis is an important cause of mastitis in dairy cattle, and pneumonia, arthritis, and otitis in calves. Milk and colostrum are considered important sources of infection for calves. knowledge on the effect of on-farm freezing (-18°C) and thawing methods on the recovery of M. bovis from colostrum samples is missing. In this study, 2 separate experiments were performed. The first experiment consisted of a longitudinal study examining the survival [as measured by log(10) reduction] of 2 M. bovis strains in frozen colostrum over 14 wk. The second experiment examined the effect of different thawing temperatures (45 and 20°C), thawing frequencies (once or twice), and initial colostrum titer (104 or 106 cfu/mL) on M. bovis survival. A single freeze-thaw cycle led to an approximate 1 log reduction of M. bovis titer, independent of the thawing temperature. Freezing for 14 wk did not significantly further reduce the titer of bacteria compared with freezing for 2 wk. A second freeze-thaw cycle further reduced the M. bovis count by approximately 0.5 log compared with a single freeze-thaw cycle. Thawing temperature and initial bacterial concentration did not significantly affect M. bovis reduction. In conclusion, storage of colostrum samples in the freezer at -18°C during epidemiological studies, herd monitoring, or test and cull programs will probably have little influence on qualitative bacteriological test results for M. bovis. The epidemiological or clinical relevance of an approximate 1 log reduction of M. bovis in colostrum is currently unclear.
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Affiliation(s)
- L Gille
- Department of Large Animal Internal Medicine, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - F Boyen
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - L Van Driessche
- Department of Large Animal Internal Medicine, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - B Valgaeren
- Department of Large Animal Internal Medicine, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - F Haesebrouck
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - P Deprez
- Department of Large Animal Internal Medicine, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - B Pardon
- Department of Large Animal Internal Medicine, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Van Driessche L, Valgaeren BR, Gille L, Boyen F, Ducatelle R, Haesebrouck F, Deprez P, Pardon B. A Deep Nasopharyngeal Swab Versus Nonendoscopic Bronchoalveolar Lavage for Isolation of Bacterial Pathogens from Preweaned Calves With Respiratory Disease. J Vet Intern Med 2017; 31:946-953. [PMID: 28425146 PMCID: PMC5435039 DOI: 10.1111/jvim.14668] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/23/2016] [Accepted: 01/09/2017] [Indexed: 12/24/2022] Open
Abstract
Background Nonendoscopic bronchoalveolar lavage (BAL) is a practical alternative for a deep nasopharyngeal swab (DNS) to sample the airways of a large number of calves in a short period of time. The extent of commensal overgrowth and agreement of BAL with DNS culture results in preweaned calves are unknown. Objectives To compare commensal overgrowth and bacterial culture results between DNS and BAL samples. Animals A total of 183 preweaned calves (144 with bovine respiratory disease and 39 healthy animals). Methods Cross‐sectional study. Deep nasopharyngeal swab and BAL samples were taken from each calf and cultured to detect Pasteurellaceae and Mycoplasma bovis. Agreement and associations between culture results of DNS and BAL samples were determined by kappa statistics and logistic regression. Results Bronchoalveolar lavage samples were less often polymicrobial, more frequently negative and yielded more pure cultures compared to DNS, leading to a clinically interpretable culture result in 79.2% of the cases compared to only in 31.2% of the DNS samples. Isolation rates were lower in healthy animals, but not different between DNS and BAL samples. Only Histophilus somni was more likely to be isolated from BAL samples. In clinical cases, a polymicrobial DNS culture result did not increase the probability of a polymicrobial BAL result by ≥30%, nor did it influence the probability of a negative culture. A significant herd effect was noted for all observed relationships. Conclusions and Clinical Relevance Nonendoscopic BAL samples are far less overgrown by bacteria compared to DNS samples under the conditions of this study, facilitating clinical interpretation and resulting in a higher return on investment in bacteriologic culturing.
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Affiliation(s)
- L Van Driessche
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - B R Valgaeren
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - L Gille
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - F Boyen
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - R Ducatelle
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - F Haesebrouck
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - P Deprez
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - B Pardon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Valgaeren B, Hanssens H, Roelandt S, Goossens E, Verherstraeten S, Gille L, Van Driessche L, Haesebrouck F, Ducatelle R, Van Immerseel F, Deprez P, Pardon B. Solid feed provision reduces fecal clostridial excretion in veal calves. VLAAMS DIERGEN TIJDS 2016. [DOI: 10.21825/vdt.v85i6.16311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Enterotoxemia is characterized by a highly fatal hemorrhagic enteritis in cattle, caused by Clostridium perfringens. Production systems with intensive feeding, such as the veal industry, are predisposed. The primary objective of this study was to determine the effect of solid feed provision on fecal C. perfringens excretion in veal calves. Ten Holstein Friesian bull veal calves were randomly assigned to one of two test diets. Group 1 received solemnly milk replacer twice daily, while group 2 received milk replacer and a maximum of 300g solid feed/day, consisting of a mixture of 30% barley, 30% corn, 30% hulled wheat and 10% chopped straw. The number of C. perfringens per g feces or fecal clostridial counts (FCC) were determined for all calves. Mean FCC were significantly lower in the calves fed milk replacer and solid feed, than in the calves fed solemnly milk replacer. Although the correlation between FCC and enterotoxemia risk remains to be determined, the provision of solid feed to veal calves reduced clostridial excretion, which might contribute to the prevention of this disease.
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Van Driessche L, Valgaeren B, Schutter PD, Gille L, Boyen F, Ducatelle R, Deprez P, Pardon B. Effect of sedation on the intrapulmonary position of a bronchoalveolar lavage catheter in calves. Vet Rec 2016; 179:18. [DOI: 10.1136/vr.103676] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/04/2022]
Affiliation(s)
- L. Van Driessche
- Department of Large Animal Internal Medicine; Faculty of Veterinary Medicine; Ghent University; Salisburylaan 133 Merelbeke 9820 Belgium
| | - B. Valgaeren
- Department of Large Animal Internal Medicine; Faculty of Veterinary Medicine; Ghent University; Salisburylaan 133 Merelbeke 9820 Belgium
| | | | - L. Gille
- Department of Large Animal Internal Medicine; Faculty of Veterinary Medicine; Ghent University; Salisburylaan 133 Merelbeke 9820 Belgium
| | - F. Boyen
- Department of Pathology; Bacteriology and Avian Diseases; Faculty of Veterinary Medicine; Ghent University; Salisburylaan 133 Merelbeke 9820 Belgium
| | - R. Ducatelle
- Department of Pathology; Bacteriology and Avian Diseases; Faculty of Veterinary Medicine; Ghent University; Salisburylaan 133 Merelbeke 9820 Belgium
| | - P. Deprez
- Department of Large Animal Internal Medicine; Faculty of Veterinary Medicine; Ghent University; Salisburylaan 133 Merelbeke 9820 Belgium
| | - B. Pardon
- Department of Large Animal Internal Medicine; Faculty of Veterinary Medicine; Ghent University; Salisburylaan 133 Merelbeke 9820 Belgium
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Janssens K, Deprez P, Valgaeren B, Van Driessche L, Gille L, Boyen F, Pardon B. Health risks associated with the use of automatic milk feeders in calves. VLAAMS DIERGEN TIJDS 2016. [DOI: 10.21825/vdt.v85i2.16348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of the present article was to summarize available evidence of the economic benefits and health risks associated with the use of automatic milk feeders (AMFs) in calves. Although AMFs are increasingly used in cattle production, clear evidence of their economic benefits (increased average daily gain, gradual weaning and reduced labor time) for the typical Belgian farm size and management is not available. Especially in smaller farms, where labor time is not a limiting factor, a careful economic consideration should be made. Regarding the association of AMFs with calf disease, studies have only been performed for bovine respiratory disease and confirmed an increased risk. However, since the use of AMFs is strongly related with several other risk factors (group housing at young age, large groups, age difference in a group, continuous system versus all-in/all-out), it is difficult to unequivocally identify the risk associated with AMFs alone. A group size of less than ten calves on a single drinking point, an all-in/allout grouping system and a minimum age at introduction to the automat of three weeks are recommended for farms with AMFs. To the authors’ knowledge, no scientific evidence supporting the presumed association of diarrhea and tongue ulcers with AMFs is available to date.
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Valgaeren B, Goossens E, Verherstraeten S, Gille L, Van Driessche L, Van Immerseel F, Ducatelle R, Deprez P, Pardon B. Gastro-intestinale Clostridium perfringens-infecties: een blijvend gevaar in de Belgische rundveehouderij. VLAAMS DIERGEN TIJDS 2016. [DOI: 10.21825/vdt.v85i1.16407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
De intensivering van de moderne landbouw wordt geassocieerd met een toename van Clostridium perfringens-gerelateerde, gastro-intestinale problemen bij intensief gevoede runderen, zoals “hemorrhagic bowel disease” bij hoogproductief melkvee en enterotoxemie bij kalveren. Waar de pathogenese van hemorrhagic bowel disease nog grotendeels ongekend is, werden er de laatste jaren nieuwe inzichten in de pathogenese van enterotoxemie bekomen die een belangrijke repercussie op de aanpak van deze ziekte onder praktijkomstandigheden hebben. Ook andere clostridiumgeassocieerde maagdarminfecties, zoals “overeating disease” en neonatale clostridiose, worden regelmatig gediagnosticeerd. Overvoedering met structuurarme, eiwitrijke voeders is een overkoepelende risicofactor bij zowel HBD, enterotoxemie als overeating disease. Een goed uitgebalanceerd dieet dat zo stabiel mogelijk gehouden wordt, is dan ook het belangrijkste aandachtspunt op bedrijven die problemen hebben met clostridiose. Daarnaast dient bij jonge kalveren voldoende aandacht gegeven te worden aan een correcte en hygiënische biestverstrekking om problemen met neonatale clostridiose te vermijden.
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Gille L, Pilo P, Valgaeren BR, Van Driessche L, Van Loo H, Bodmer M, Bürki S, Boyen F, Haesebrouck F, Deprez P, Pardon B. A new predilection site of Mycoplasma bovis: Postsurgical seromas in beef cattle. Vet Microbiol 2016; 186:67-70. [PMID: 27016759 DOI: 10.1016/j.vetmic.2016.02.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 02/17/2016] [Indexed: 11/17/2022]
Abstract
Mycoplasma bovis is a highly contagious bacterium, which predominantly causes chronic pneumonia, otitis and arthritis in calves and mastitis in adult cattle. In humans, Mycoplasma species have been associated with post-surgical infections. The present study aimed to identify the bacteria associated with three outbreaks of infected seromas after caesarian section in Belgian Blue beef cattle. A total of 10 cases occurred in three herds which were in close proximity of each other and shared the same veterinary practice. M. bovis could be cultured from seroma fluid in five of the six referred animals, mostly in pure culture and was isolated from multiple chronic sites of infection (arthritis and mastitis) as well. DNA fingerprinting of the isolates targeting two insertion sequence elements suggested spread of M. bovis from chronic sites of infection (udder and joints) to the postsurgical seromas. Identical genetic profiles were demonstrated in two animals from two separate farms, suggesting spread between farms. Mortality rate in the referred animals positive for M. bovis in a seroma was 80% (4/5), despite intensive treatment. A massive increase in antimicrobial use was observed in every affected farm. These observations demonstrate involvement of mycoplasmas in outbreaks of postsurgical seromas in cattle.
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Affiliation(s)
- L Gille
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - P Pilo
- Department of Infectious Diseases and Pathobiology, Institute of Veterinary Bacteriology, 122 Laenggassstrasse, Postfach 8466, CH-3001 Bern, Switzerland
| | - B R Valgaeren
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - L Van Driessche
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - H Van Loo
- Animal Health Service Flanders, DGZ Vlaanderen, Deinse Horsweg, 9031 Drongen, Belgium
| | - M Bodmer
- Department for Clinical Veterinary Medicine, Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109A, 3001 Bern, Switzerland
| | - S Bürki
- Department of Infectious Diseases and Pathobiology, Institute of Veterinary Bacteriology, 122 Laenggassstrasse, Postfach 8466, CH-3001 Bern, Switzerland
| | - F Boyen
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - F Haesebrouck
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - P Deprez
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - B Pardon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Vanhaverbeke M, Sarens T, Driessche LV. Friable coronary arteries are link between pathogenesis and treatment of spontaneous coronary artery dissection. Acta Clin Belg 2014; 69:217-20. [PMID: 24712892 DOI: 10.1179/2295333714y.0000000020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Spontaneous coronary artery dissection (SCAD) is increasingly being diagnosed as the cause of an acute coronary syndrome, especially in young patients. We report the case of a 32-year-old woman with postpartum SCAD of the left main and left anterior descending coronary artery which required the implantation of two drug-eluting stents. We present a literature study that correlates the pathogenesis of SCAD to the treatment options. Non-atherosclerotic SCAD is clearly associated with connective tissue disorders, vasculitis, and the peripartum period with its hormonal and haemodynamic changes. The coronary arteries of these SCAD patients are friable and should be approached with caution. Percutaneous coronary intervention has a reported success rate of only 65% and may cause propagation of the dissection. Lately, more and more authors suggest the possibility of a conservative approach in the absence of remaining cardiac ischaemia, even in this era of percutaneous stent implantation.
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