STATE-OF-THE-ART PAPER
Acute Myocardial Infarction Associated With Pregnancy
Arie Roth, MD* and
Uri Elkayam, MD ,*
* Department of Cardiology Tel Aviv Sourasky Medical Center, Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel
Division of Cardiovascular Medicine and Department of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, California.
Manuscript received January 3, 2008;
revised manuscript received March 11, 2008,
accepted March 18, 2008.
* Reprint requests and correspondence: Dr. Uri Elkayam, USC/LAC Medical Center, 1200 N. State Street, Los Angeles, California 90064. (Email: elkayam{at}usc.edu).
Acute myocardial infarction (AMI) during pregnancy or the early post-partum period is rare but has been shown to be associated with poor maternal as well as fetal outcome. Major changes in both diagnosis and treatment of AMI in the nonpregnant patient have lead to improved outcome which may also affect pregnant patients. The purpose of this paper is to review available information related to the pathophysiology and clinical profile and provide recommendations for the diagnosis and management of AMI occuring during pregnancy and the early post-partum period.
Key Words: myocardial infarction • pregnancy • women
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Abbreviations and Acronyms
| | ACE = angiotensin-converting enzyme | | AMI = acute myocardial infarction | | ARB = angiotensin receptor agonist | | CABG = coronary artery bypass graft | | CCB = calcium-channel blocker | | LMWH = low-molecular-weight heparin | | MI = myocardial infarction | | PCI = percutaneous coronary intervention | | RCA = right coronary artery | | TT = thrombolytic therapy | | UFH = unfractionated heparin |
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