What is the most likely aetiology of an anterior ST-elevation myocardial infarction in a young woman shortly after childbirth?

Anterior ST-elevation myocardial infarction (STEMI) in a young woman shortly after childbirth is most commonly associated with coronary artery dissection. This condition involves a tear in the artery wall, which can lead to the formation of a false lumen and obstruction of blood flow. The peripartum period can significantly increase the risk of coronary artery dissection due to physiological changes, including increased blood volume, vascular remodeling, and hormonal fluctuations that affect the integrity of the vascular system.

In the context of recent childbirth, factors such as stress, hormonal changes, and the increased demands placed on the cardiovascular system can contribute to the occurrence of dissections. The condition is particularly relevant in young women who otherwise may not have a significant history of cardiovascular disease, making it a noteworthy consideration in this demographic.

While the other conditions listed can lead to myocardial infarctions, they are less likely to be the immediate cause in this specific scenario. Atherosclerotic plaque rupture is typically associated with older patients and those with established risk factors for coronary artery disease. Myocardial bridging involves the heart muscle overlying a coronary artery, and while it can sometimes present with chest pain, it is rarely linked to acute myocardial infarctions. Takotsubo cardiomyopathy, often