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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

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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