Acute Coronary Syndrome During Pregnancy: A Case Report and Literature Review

Abstract

SUMMARYA 32-year-old multiparous woman who presented with chest pain at seven weeks gestation was admitted to our hospital 35 minutes after the onset of symptoms. Sudden cardiac arrest developed while the patient was waiting in the triage room. Cardiopulmonary resuscitation was performed, and the patient was immediately intubated. Electrocardiography revealed an inferior myocardial infarction. The patient underwent coronary angiography, which revealed slow coronary flow of the circumflex and left anterior descending coronary arteries. For treatment, the combination of aspirin with clopidogrel and unfractionated heparin was initiated. She had previously had three healthy children and hadn't had any problems during her previous pregnancies. She had a history of family and smoking, but no history of other coronary risk factors such as diabetes mellitus, hypertension, or dyslipidemia. She was discharged home on day five after admission with clopidogrel, aspirin and a beta-blocker with close outpatient follow-up. Elective abortion was planned for two weeks after the myocardial infarction.

Acute Myocardial Infarction in a Patient with Twin Pregnancy: A Case Report

“…Most AMIs will occur during the third trimester and peak around the peripartum and postpartum periods. 5 Pregnant patients are a vulnerable population that may present with atypical signs and symptoms, inconsistent with classic anginal symptoms such as chest pain, shortness of breath, diaphoresis, and nausea. Symptoms may be dismissed as disorders common to pregnancy including gastroesophageal reflux, musculoskeletal complaints, and shortness of breath due to a cephalad deviation of abdominal organs.…”

Complexities of oral antiplatelet drugs use in pregnancy

“…One week prior to delivery, acetylsalicylic acid and clopidogrel were discontinued and replaced with low molecular weight heparin until the delivery. Successful caesarian section was performed and a healthy child was born [38].…”

Update in Glycoprotein IIb/IIIa Receptor Antagonist Clopidogrel: Use in Cerebrovascular Accidents

“…Although there is limited data on this specific situation, authors commented that CLP use in pregnancy has not been shown to convey important toxicity to either the mother or the neonate. Furthermore, Yilmaz et al have stressed that a seven-week pregnant woman diagnosed with acute myocardial infarction was treated accordingly and was discharged home with a beta blocker, clopidogrel and ASA [24].…”