Acute myocardial infarction in pregnancy: Current diagnosis and management approaches

Edupuganti, Mohan Mallikarjuna Rao; Ganga, V La

doi:10.1016/j.ihj.2019.12.003

Cited by 26 publications

(28 citation statements)

References 41 publications

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“…Little information from low- and middle-income countries exists regarding sudden onset pregnancy-related cardiac disease. [ 7 ] Considering a vast majority of births occur at primary care level, availability of skilled obstetric care with efficient referral services would significantly lower the cases of maternal mortality and fetal compromise due to cardiac disease.…”

Section: Discussionmentioning

confidence: 99%

“…Previous MI is not an absolute contraindication to subsequent pregnancies; however, pre-conception care must involve full cardiac evaluation with electrocardiogram, stress test, echocardiography, and possibly assessment of the coronary arteries to determine risk. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

“…Once pregnancy is diagnosed, patients' physical activity and cardiac symptoms should be reviewed and activities should be restricted where necessary. [ 7 9 ] Regular follow-up should ideally occur in facilities with access to specialist care, as patients remain at a risk of ischemia and associated complications as pregnancy advances.…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy-associated myocardial infarction following elective caesarean section for two previous caesarean sections and myomectomy

Oreh

Imagbenikaro²,

Adelaja³

et al. 2020

J Family Med Prim Care

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A 39-year-old woman, gravida 4, para 2 + 1 (2 alive) for elective second repeat caesarean delivery on account of two previous caesarean sections and one open myomectomy. Following the caesarean section, she developed sudden cardiac failure and was transferred to the intensive care unit for mechanical ventilation support. Congestive cardiac failure secondary to non ST segment elevation myocardial infarction (NSTEMI) was subsequently diagnosed following an electrocardiogram (ECG), echocardiography, and cardiac enzyme assay. The presented case demonstrates the importance of skilled delivery and efficient referral services in developing countries to minimize poor maternal and fetal outcomes in pregnancy-related heart disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pregnancy-associated myocardial infarction following elective caesarean section for two previous caesarean sections and myomectomy

Oreh

Imagbenikaro²,

Adelaja³

et al. 2020

J Family Med Prim Care

View full text Add to dashboard Cite

show abstract

“…13 An algorithm for the pharmaceutical management of AMI during pregnancy has been published. 81 Timing and Mode of Delivery in Acute MI ESC guidelines advise that the treatment of STEMI/NSTEMI should not be delayed for delivery. 13 In an acute situation, the priority is to stabilise and treat the mother.…”

Section: Secondary Prevention Post-pcimentioning

confidence: 99%

Diagnostic Angiograms and Percutaneous Coronary Interventions in Pregnancy

Khaing

Kunadian

2020

Interv Cardiol

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Cardiovascular disease is the leading indirect cause of maternal mortality in the UK. Pregnancy increases the risk of acute MI (AMI) by three- to fourfold secondary to the profound physiological changes that place an extra burden on the cardiovascular system. AMI is not always recognised in pregnancy and there is concern among both clinicians and patients regarding catheter-based interventions due to fears of foetal irradiation and risks to the foetus. This article evaluates the current state of knowledge on AMI in pregnancy with particular emphasis on pregnancy-associated spontaneous coronary artery dissection and percutaneous coronary intervention as the revascularisation procedure for AMI. Special considerations that must be made in patients requiring percutaneous coronary intervention for pregnancy-associated spontaneous coronary artery dissection and the current recommendations on arterial access, methods of minimising radiation and stent selection are discussed.

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“…This syndrome is very rare in pregnancy. It is important to quickly recognize it and implement a treatment in order to reduce mortality and further perinatal complications [1,2]. It should be taken into account that OSW is a condition that can lead to sudden cardiac arrest (SCA) defined as a significant impairment of the mechanical function of the heart muscle, which is manifested by the patient's lack of response to stimuli, imperceptible pulse, and apnea or agonizing breath.…”

mentioning

confidence: 99%

Sudden cardiac arrest as a result of anterior and lateral myocardial infarction at 16 weeks of gestation - case report

Wójcik¹,

Obuchowska²,

Obuchowska³

et al. 2020

J Educ Health Sport

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Introduction: Sudden cardiac arrest (SCA) is defined as a significant impairment of the mechanical function of the heart muscle, characterized by the patient's lack of response to stimuli, no perceptible pulse and apnea or agonal breathing, most often caused by acute coronary syndrome (ACS). ACS during pregnancy is a rare phenomenon and its incidence increases with the age of giving birth. The most common cause of ACS in pregnancy are typical changes in the etiology of atherosclerosis or coronary artery thrombosis. Other factors increasing the risk of a heart attack are arterial hypertension, diabetes, obesity and lipid disorders. Aim of study: To describe a rare clinical case and demonstrate the importance of maintaining cardiac vigilance in pregnant patients. Clinical case report: A 32-year-old patient, at 16 weeks of gestation, hospitalized due to an anterior and lateral ST Elevation Myocardial Infarction (STEMI), complicated by SCA due to the mechanism of ventricular fibrillation. The patient was qualified for invasive reperfusion treatment which included left anterior descending (LAD) coronary artery surgery with drug eluting stent (DES) implantation and ballooning of the diagonal first coronary artery. Echocardiography done after treatment revealed apical hypokinesia and left ventricular ejection fraction of 70%. Subsequently the patient was kept under obstetrical and cardiological care. At 37 weeks of gestation, the pregnancy was finished by a successful caesarean section. Conclusion: Pregnancy is a state of hypercoagulability and decreased activity of the fibrinolytic system. The clinical management in this case does not differ from the clinical procedure adopted for non-pregnant women. It is important to make a diagnosis quickly and implement a life-saving procedure as soon as possible.

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Acute myocardial infarction in pregnancy: Current diagnosis and management approaches

Cited by 26 publications

References 41 publications

Pregnancy-associated myocardial infarction following elective caesarean section for two previous caesarean sections and myomectomy

Pregnancy-associated myocardial infarction following elective caesarean section for two previous caesarean sections and myomectomy

Diagnostic Angiograms and Percutaneous Coronary Interventions in Pregnancy

Sudden cardiac arrest as a result of anterior and lateral myocardial infarction at 16 weeks of gestation - case report

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