Pregnancy-related acute myocardial infarction: A review of epidemiology, Diagnosis, Medical and surgical management

Abstract

Although acute myocardial infarction (AMI) in pregnancy is rare, can result in maternal and/or fetal death and should be carefully managed. The aim of this study is to collect and review the data on the management from numerous articles published since 2000. For literature review we performed a literature search on PubMed that were based on diagnoses and management of myocardial infarction on pregnancy. Atherosclerosis appears to be the most common cause of AMI. Although there are some differences related to pregnancy stage such as thrombosis, coronary artery spasm or dissection that seen more frequently in pregnant women than age- matched nonpregnant women. In addition to traditional risk factors of atherosclerosis in general population, some other risk factors due to physiological or pathological changes in pregnancy and also some drugs can cause AMI. The Presentation and diagnosis of AMI in pregnancy usually is the same as nonpregnant patients but there are some important points. Regardless of some differences, therapeutic option of AMI in pregnant women is the same of nonpregnant patients. Probably primary percutaneous coronary intervention is the optimal medical management of AMI during pregnancy. Use of thrombolytic therapy in pregnancy is prohibited and is very limited. Although there have been many reports of cardiopulmonary bypass surgery during pregnancy, most knowledge is based on anecdotal and old reports. Early detection and multidisciplinary approach and timely delivery can minimize the serious consequences of AMI in pregnancy.