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Articles

Title: Acute myocardial infarction during pregnancy

Author:
Beata Wożakowska-Kapłon, Marianna Janion, Justyna Niedziela, Anna Polewczyk
Type:
type 5
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
2002
Volume:
4
Number:
2
Start page:
165
Final page:
169
ISSN:
1507-5540
Keywords:
pregnancy, acute myocardial infarction
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Acute myocardial infarction in pregnancy has an incidence of 1 in 10 000. The highest incidence occurs in the third trimester and in multigravidas older than 33 years of age. Pregnancy imposes increasing stress upon the cardiovascular system throughout normal pregnancy and particularly during delivery. Both the blood vo-lume and the basal cardiac output increase by 40-50%. These changes of pregnancy may cause worse-ning of ichemia. Acute myocardial infarction during pregnancy is most commonly located in the anterior wall. This rare peripartum event is accompanied by significant maternal and fetal mortality ranging from 25-48%. Mortality isincreased if the infarct occurs in the third trimester, ifthe patient is under age 35year, if she de-livers within 2 weeks of her infarct, and if she has cesarean section. Up to now 140 cases of myocardial infarction during pregnancy have been reported, and angiography revealed normal findings in 29-47% of cases. In patients with normal coronary angiography, thrombosis, coronary spasm and coronary artery dis-section have been discussed as the major mechanisms of the myocardial infarction. There are no strict guidelines regarding the best method of treatment and delivery in pregnant patients with acute myocardial infarction. However, the selection of diagnostic and treatment approaches may be greatly influenced by fetal safety. Therapeutic options in such condition are discussed and review of relevant literature is presented.