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Heart. 2018 Nov 15. pii: heartjnl-2018-313454. doi: 10.1136/heartjnl-2018-313454. [Epub ahead of print]

Ischaemic heart disease and pregnancy.

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Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK.
Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.


Although ischaemic heart disease is currently rarely encountered in pregnancy, occurring between 2.8 and 6.2 per 100‚ÄČ000 deliveries, it is becoming more common as women delay becoming pregnant until later life, when medical comorbidities are more common, and because of the higher prevalence of obesity in the pregnant population. In addition, chronic inflammatory diseases, which are more common in women, may contribute to greater rates of acute myocardial infarction (AMI). Pregnancy itself seems to be a risk factor for AMI, although the exact mechanisms are not clear. AMI in pregnancy should be investigated in the same manner as in the non-pregnant population, not allowing for delays, with investigations being conducted as they would outside of pregnancy. Maternal morbidity following AMI is high as a result of increased rates of heart failure, arrhythmia and cardiogenic shock. Delivery in women with history of AMI should be typically guided by obstetric indications not cardiac ones.


coronary artery disease; pregnancy

Conflict of interest statement

Competing interests: None declared.

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