March 2025
In a peripartum woman presenting with severe acute chest and/or thoracic backpain, it is important to consider the possibility of an aortic or coronary dissection; this is particularly the case where there are electrocardiogram (ECG) abnormalities. Ideally, an echocardiogram (where possible transoesophageal) should be performed, with the alternative of a CT aortogram suggested in the postpartum period. Echocardiography is available in many large emergency departments, usually via the cardiology service and can be performed at any hour if needed.