Mid-ventricular Obstructive Hypertrophic Cardiomyopathy during Pregnancy Complicated by Preeclampsia and Acute Myocardial Infarction: A Case Report

Singla, Anand; Lipshultz, Steven E.; Fisher, Stacy D.

doi:10.1111/j.1747-0803.2010.00453.x

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…To our knowledge, this is only the second report of peripartum AMI associated with LVH and the previously reported, “basal septal bulge.” In the first published such case report, the patient was found to have a gene mutation associate with hypertrophic cardiomyopathy (Singla, Lipshultz, & Fisher, 2011). Our case highlights the maladaptive cardiac remodeling that occurs with pre‐eclampsia, which may predispose such patient to AMI via a unique, nonthrombotic mechanism.…”

Section: Discussionmentioning

confidence: 99%

Subendocardial stress in pre‐eclampsia

Tran

Farasat

Krantz

2020

Noninvasive Electrocardiol

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A primigravida 26‐year‐old woman who had developed pre‐eclampsia with malignant hypertension at 30 weeks of gestation suffered acute myocardial infarction two days postpartum. Electrocardiogram demonstrated diffuse ST‐segment depression suggestive of subendocardial ischemia. Echocardiography demonstrated focal asymmetric left ventricular hypertrophy, with a characteristic “basal septal bulge”, and a left ventricular mid‐cavitary gradient of 51 mmHg. Coronary angiography revealed normal coronary arteries and vascular flow. Peripartum acute myocardial infarction is rare and portends a high mortality. However, to date, only one case of acute myocardial infarction associated with asymmetric left ventricular hypertrophy and pre‐eclampsia has been described in the literature.

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Section: Discussionmentioning

confidence: 99%

Subendocardial stress in pre‐eclampsia

Tran

Farasat

Krantz

2020

Noninvasive Electrocardiol

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Pregnancy-Associated Acute Myocardial Infarction

et al. 2014

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1695T he incidence of coronary artery disease (CAD) in women of child-bearing age is low, and acute myocardial infarction (AMI) is uncommon.1,2 Pregnancy, however, has been shown to increase the risk of AMI ≈3-fold compared with the risk in nonpregnant women of similar age. [2][3][4][5] Although previous studies have provided some data related to the incidence of pregnancyassociated MI (PAMI), clinical characteristics, risk factors, and outcome 1,2,4 more information is needed on the mechanisms of AMI, the efficacy and safety of standard therapy, and the applicability of guideline recommendations designed for the general AMI population, to women with PAMI.The aim of this study was therefore to review contemporary data on PAMI in an attempt to provide recommendations for the management of this condition. MethodsA literature search for cases with AMI related to pregnancy was performed using PubMed and Google Scholar. References from these studies were cross-checked to obtain additional studies that may have been missed by the original search.All original articles were obtained online or by interlibrary communication. Articles published in languages other than English were translated by medical translators. A total of 134 cases published in the literature from 2006 to 2011 not included in a previous review 4 were included in this study. In addition, 7 cases presented at the First International Congress on Cardiac Problems in Pregnancy in 2010 (Valencia, Spain) and 9 patients treated or consulted by the authors were also included in the analysis. Recommendations were made on the basis of available clinical information, with the understanding that the cases published in the literature and reviewed by us do not represent all the patients who developed PAMI during the period of the study and that reporting may therefore be incomplete and biased. ResultsOne hundred fifty patients with PAMI were included in the study (Table 1). The age ranged from 17 to 52 years; the mean age was 34±6 years; 75% of the patients were >30 years of age; and 43% were >35 years. Reported risk factors for CAD included smoking in 25% of the patients, dyslipidemia in 20%, hypertension in 15%, and diabetes mellitus and a family history of CAD in 9% each.The type and timing of AMI are shown in Figure 1. Data on the type of AMI were available in 139 of the patients. Of these, 105 (75%) presented with ST-segment-elevation MI (STEMI) and the rest with non-STEMI (NSTEMI). The majority of the patients developed AMI during either the third trimester of pregnancy (STEMI, 25%; NSTEMI, 32%) or the postpartum period (STEMI, 45%; NSTEMI, 55%). The myocardial infarct involved the anterior wall of the left ventricle (LV) in 69% of the patients, the inferior wall in 27%, and the lateral wall in 4%. Table 2 shows the mechanisms of AMI. Coronary angiography was performed in 129 patients and demonstrated coronary dissection (CD) in 56 patients (43%), atherosclerotic disease in 27%, a clot without angiographic evidence for atherosclerotic disease in 22 patients (1...

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Mid-ventricular Obstructive Hypertrophic Cardiomyopathy during Pregnancy Complicated by Preeclampsia and Acute Myocardial Infarction: A Case Report

Cited by 2 publications

References 15 publications

Subendocardial stress in pre‐eclampsia

Subendocardial stress in pre‐eclampsia

Pregnancy-Associated Acute Myocardial Infarction

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