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The risk of acute myocardial infarction in young women is low, but increases during pregnancy due to the physiological changes in pregnancy, including hypercoagulability. Ischaemic heart disease during pregnancy is not only associated with increased maternal morbidity and mortality, but also with high neonatal complications. Advancing maternal age and other risk factors for cardiovascular diseases may further increase the risk of ischaemic heart disease in young women.
We searched the coronary angiography database of a Dutch teaching hospital to identify women with acute myocardial infarction who presented during pregnancy or postpartum between 2011 and 2013.
We found two cases. Both women were in their early thirties and both suffered from myocardial infarction in the postpartum period. Acute myocardial infarction was due to coronary stenotic occlusion in one patient and due to coronary artery dissection in the other patient. Coronary artery dissection is a relatively frequent cause of myocardial infarction during pregnancy. Both women were treated by percutaneous coronary intervention and survived.
Physicians should be aware of the increased risk of myocardial infarction when encountering pregnant or postpartum women presenting with chest pain.
European Society of Gynecology, Association for European Paediatric Cardiology, German Society for Gender Medicine, Regitz-Zagrosek V, Blomstrom Lundqvist C, et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:3147–97. CrossRef
Regitz-Zagrosek V, Jaguszewska K, Preis K. Pregnancy-related spontaneous coronary artery dissection. Eur Heart J. 2015;36:2273–4. PubMed
Regitz-Zagrosek V, Seeland U, Geibel-Zehender A, Gohlke-Barwolf C, Kruck I, Schaefer C. Cardiovascular diseases in pregnancy. Dtsch Arztebl. 2011;108:267–73.
- Pregnancy-related myocardial infarction
M. C. Lont
A. J. van Boven
P. W. Boonstra
P. G. Pieper
- Bohn Stafleu van Loghum