AIMS: To present a rare case of a post-partum spontaneous coronary artery 
dissection (SCAD), a rarely seen condition which does not yet have a universally 
agreed treatment method and the role of the intensive care unit (ICU) nurse when 
caring for the adult ECMO patient.
BACKGROUND: The use of extra-corporeal membrane oxygenation (ECMO) for the adult 
patient has increased slowly since the first reported successful treatment in 
1972 (Hill et al., 1972) and is seen increasingly as a successful therapy when 
conventional medical treatment has failed. In this case, a young lady 2 weeks 
post-partum presented with acute coronary syndrome secondary to a SCAD. ECMO was 
used successfully as a bridge to myocardial recovery following coronary artery 
bypass grafts and cardiogenic shock.
DESIGN AND METHOD: A case study underpinned by a review of existing literature 
relating to spontaneous coronary artery dissection and extra-corporeal membrane 
oxygenation.
RESULTS AND CONCLUSIONS: ECMO is still a relatively new and invasive technology 
but continues to improve survival rates in critically ill patients where 
conventional medical treatment has failed. This article highlights requirement 
for further research into several aspects of care for the adult ECMO patient. 
Questions to be answered raised in this case study include recommendations for 
the weaning of inotropes and vasoconstrictors, frequency of blood gas sampling 
and whether it remains essential to have two nurses caring for the ECMO patient.
RELEVANCE TO CLINICAL PRACTICE: As medical treatment progresses, there is an 
increasing demand for therapies such as ECMO to become more readily available 
for the care of the critically ill adult patient. This article highlights 
challenges that may be faced and what changes could be made to further improve 
standards of care and survival rates for ECMO patients.