Acute Myocardial Infarction and Pregnancy

Elkayam, Uri; Havakuk, Ofer

doi:10.1002/9781119409861.ch14

Cited by 2 publications

(5 citation statements)

References 88 publications

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“…Gestational AMI is rare, but it is a well-described complication. The criteria for the diagnosis of AMI in pregnant women are the same as those in nonpregnant patients and consist primarily of symptoms, electrocardiographic changes, and cardiac markers[ 3 ]. Based on the patient’s symptoms and examinations results, she was definitively diagnosed with AMI.…”

Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction in twin pregnancy after assisted reproduction: A case report

Dai¹,

Zhou²,

Zhuo³

et al. 2021

WJCC

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BACKGROUND Acute myocardial infarction (AMI) during pregnancy is rare, especially in twin pregnancy, and it can endanger the lives of the mother and children. Except for conventional cardiovascular risk factors, pregnancy and assisted reproduction can increase the risk of AMI during pregnancy. AMI develops secondary to different etiologies, such as coronary spasm and spontaneous coronary artery dissection. CASE SUMMARY A 33-year-old woman, with twin pregnancy in the 31 st week of gestation, presented to the hospital with intermittent chest tightness for 12 wk, aggravation for 1 wk, and chest pain for 4 h. Combined with the electrocardiogram and hypersensitive troponin results, she was diagnosed with acute ST-elevation myocardial infarction. Although the patient had no related medical history, she presented several risk factors, such as age greater than 30 years, assisted reproduction, and hyperlipidemia. After diagnosis, the patient received antiplatelet and anticoagulant treatment. Cesarean section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary artery. After receiving medication, the patient was in good condition. CONCLUSION This case suggests that, with the widespread use of assisted reproductive technology, more attention should be paid to perinatal healthcare, especially when chest pain occurs, to facilitate early diagnosis and intervention of AMI, and the etiology of AMI in pregnancy needs to be differentiated, especially between coronary spasm and spontaneous coronary artery dissection.

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Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction in twin pregnancy after assisted reproduction: A case report

Dai¹,

Zhou²,

Zhuo³

et al. 2021

WJCC

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“…If indicated, treatment can be continued after delivery. Both heparin and LMWH are not excreted into breast milk and therefore safe for lactation [12], [15].…”

Section: Therapymentioning

confidence: 99%

“…Beta-blockers may reduce both myocardial oxygen consumption and shear stress in SCAD and it has been used in pregnancy for the management of hypertension, mitral stenosis, Marfan syndrome, and myocardial ischemia [1], [15]. Propranolol is considered safe in pregnancy, metoprolol is well tolerated and used for SVT and ventricular arrhythmias in pregnancy, and labetalol is used as first line for both acute and chronic hypertension in pregnancy, but dose adjustment is needed due to increasing clearance shorter half-life.…”

Section: Review Articlementioning

confidence: 99%

“…Propranolol is considered safe in pregnancy, metoprolol is well tolerated and used for SVT and ventricular arrhythmias in pregnancy, and labetalol is used as first line for both acute and chronic hypertension in pregnancy, but dose adjustment is needed due to increasing clearance shorter half-life. However, neonates exposed to betablockers had significantly more bradycardia and hypoglycemia and were often associated with fetal growth restriction [14], [15], [21].…”

Section: Review Articlementioning

confidence: 99%

“…Nifedipine is part of calcium-channel blockers which commonly used in the treatment of hypertension, pre-eclampsia, and tocolysis, and verapamil is the second line for rate control in AF and treatment of idiopathic sustained VT in pregnant women [12], [15]. Those are excreted in human milk, therefore.…”

Section: Review Articlementioning

confidence: 99%

See 2 more Smart Citations

Myocardial Infarction in Pregnancy: What Should We Do?

Laksono,

Lukita Wening

2024

SEE J Cardiol

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Acute myocard infarct during pregnancy is a rare event with high mortality and women with cardiac comorbid such as hypercholesterolemia, hypertension, and history of myocardial infarction are one of risk that should be warning. However, the main etiology myocard infarct in pregnancy is spontaneous coronary artery dissection, especially in the third semester. Women with unusual chest pain, ST-elevation in electrocardiogram, and sudden cardiac arrest should treat as soon as possible. Patient with unstable condition revascularization is recommended. However, there are several things that should be monitor during revascularization such as consideration type of stent, how much contrast that will be use, and planning after stent implantation. Thrombolysis should be the last option because of bleeding risk. Therapy during and after pregnancy should be monitor continuously because of their side effect to mother and baby, and delivery in women with acute myocard infarct should be one of main concerns. With this review, we hope that we can raise our awareness in pregnant women with their comorbid and their future pregnancy.

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Acute Myocardial Infarction and Pregnancy

Cited by 2 publications

References 88 publications

Acute myocardial infarction in twin pregnancy after assisted reproduction: A case report

Acute myocardial infarction in twin pregnancy after assisted reproduction: A case report

Myocardial Infarction in Pregnancy: What Should We Do?

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