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Indian Heart J. 2013 Jul-Aug;65(4):464-8. doi: 10.1016/j.ihj.2013.06.016. Epub 2013 Jul 12.

Acute myocardial infarction during pregnancy: a clinical checkmate.

Author information

1
New York Hospital Queens, Weill Medical College of Cornell University, New York 11355, USA. Electronic address: jais.abhishek@gmail.com.

Abstract

Acute myocardial infarction (AMI) in pregnancy is associated with high morbidity and mortality. Management of these patients can be challenging as little is known about the optimal management strategy. Medications routinely used may have harmful effects on the pregnancy outcome. In addition, AMI could occur in the absence of atherosclerotic disease. We describe optimal management strategy by eliciting the management of a 45-year-old female with ST segment elevation myocardial infarction. We recommend early use of coronary angiography to define the pathology in such cases. Radial artery assess should be preferred. Pregnant patients with AMI due to atherosclerotic disease should be given a 325 mg of aspirin and 600 mg of clopidogrel and either balloon angioplasty or bare metal stent should be used for revascularization. Percutaneous coronary intervention with heparin is preferred over bivalirudin and later should be reserved for patients with severe heparin allergy.

KEYWORDS:

Acute myocardial infarction in pregnancy; Atherosclerotic heart disease in pregnancy; Coronary dissection in pregnancy

PMID:
23993012
PMCID:
PMC3860695
DOI:
10.1016/j.ihj.2013.06.016
[Indexed for MEDLINE]
Free PMC Article

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