A clinical observation of delivery for multiple pregnancy in a patient with large-focal myocardial infarction in the history and with coronary artery stenting

Баринов, С. В.; Poltanova, A. A.; Plekho, R. M.; Starikov, N. V.; Krolevets, E. N.; Medyannikova, I. V.; Tirskaya, Yu. I.; Шамина, И. В.; Kovaleva, Yu. A.; Shlapakov, O. V.

doi:10.17116/rosakush20191901176

Cited by 2 publications

(2 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…с преобладанием инсультов [14]. В отечественной литературе присутствуют описания ОИМ у беременных с НТ [15], но обследования на ее наличие проводятся не всегда [4]. Наиболее серьезное нарушение -сочетание гетерозиготных мутаций генов фактора Лейдена, протромбина и МТГФР, особенно у женщин и молодых мужчин [16].…”

Section: обсуждение и заключениеunclassified

“…и венозные тромбозы [3]. Поражение артериального русла, в том числе коронарных артерий, встречается гораздо реже, в связи с чем эта патология не всегда ассоциируется с наследственной склонностью к тромбозам и, следовательно, не всегда служит поводом к обследованию на НТ в подобных случаях инфаркта миокарда [4].…”

unclassified

See 1 more Smart Citation

Clinical cases of myocardial infarction in pregnant women: the role of hereditary thrombophilia

et al. 2020

View full text Add to dashboard Cite

Acute myocardial infarction during pregnancy is a threatening complication with high maternal and perinatal mortality. According to the literature, hereditary thrombophilia is commonly associated with obstetric disorders and susceptibility to venous thrombosis, whereas arterial part of the vasculature, including coronary, is rarely involved. The article describes two clinical cases of pregnant women with acute myocardial infarction and post-infarction cardiosclerosis, in whom hereditary thrombophilia, associated with the gene PAI-1-675 polymorphism, was diagnosed. Mothers of both patients had suffered myocardial infarction at a young age, while past history of only one pregnant woman was remarkable for multiple perinatal losses. Myocardial infarction may manifest with intense headache mirroring systemic angiospasm. Based on the clinical observations of acute myocardial infarction in pregnancy, one could conclude that measurements of troponin levels that might be false negative should be done repeatedly, while the signs of transmural myocardial injury at ECG can evolve into those of an intramural myocardial infarction. Miscarriage and fetoplacental insufficiency have been found in the patients with combination of hereditary thrombophilia and myocardial injury. Coronary artery damage in pregnant women can be the result of hereditary thrombophilia, most often associated with the PAI-1-675 gene polymorphism, as well as its combination with the heterozygous state of other genes. The absence of past perinatal losses and venous thromboembolism in pregnant women with myocardial infarction does not exclude hereditary thrombophilia, and additional work-up of the patient and the proband family is mandatory to exclude the underlying pathology. The course of myocardial infarction may not require an intracoronary intervention, and treatment may consist of non-fractionated or low molecular weight heparin and calcium antagonists.

show abstract

Section: обсуждение и заключениеunclassified

unclassified

Clinical cases of myocardial infarction in pregnant women: the role of hereditary thrombophilia

et al. 2020

View full text Add to dashboard Cite

show abstract

Myocardial infarction in pregnancy: Current topical issues in diagnostics and treatment

Vasilchenko

Alidzhanova

Bratishchev

2022

Medicinskij alfavit

View full text Add to dashboard Cite

Lately due to the increase of childbearing age of women, high prevalence of cardiovascular diseases, and, presumably, due to the usage of some medications, there was an increase in myocardial infarction (MI) cases in pregnant women. Risk factors and pathophysiological mechanisms of MI in pregnant women differ from the general population, and are heterogeneous. Pregnancy and childbirth can be defined as ‘physiological stress’ for the cardiovascular system, which can cause MI. Abrupt changes in hemodynamics and increased coagulation state during pregnancy, in childbirth or in the early postpartum period can provoke sudden constriction (vasospasm) of a coronary artery (CA), as well as non-atherosclerotic spontaneous CA dissection, which leads to a critical decrease in the supply of oxygen to the heart muscle. The frequency of hemodynamically significant atherosclerosis of CA is also increasing. The incidence of maternal, perinatal mortality and obstetric complications is higher than in women without history of acute coronary syndrome. Over the past few decades, the diagnosis and treatment of myocardial infarction improved, the number of primary percutaneous coronary interventions in pregnant women increased, and there is now less inpatient mortality. However, due to the absence of large randomized clinical trials on the MI in pregnant women it is impossible to develop a unified algorithm for the management and preventive measures for this condition, thereby it is difficult to select an optimal treatment tactic, and hard to predict subsequent cardiovascular events. In this article we analyzed current data on MI during pregnancy, childbirth, and the postpartum period.

show abstract

A clinical observation of delivery for multiple pregnancy in a patient with large-focal myocardial infarction in the history and with coronary artery stenting

Cited by 2 publications

References 4 publications

Clinical cases of myocardial infarction in pregnant women: the role of hereditary thrombophilia

Clinical cases of myocardial infarction in pregnant women: the role of hereditary thrombophilia

Myocardial infarction in pregnancy: Current topical issues in diagnostics and treatment

Contact Info

Product

Resources

About