Prosthetic valve thrombosis presenting as an acute embolic myocardial infarction in a pregnant patient: issues on anticoagulation regimens and thrombolytic therapy.
Mechanical valves are inherently thrombogenic and require meticulous anticoagulation. Pregnancy produces a hypercoagulable state and achieving adequate anticoagulation is difficult. We present a pregnant patient who had a nonobstructive thrombus of mechanical mitral valve causing embolic acute myocardial infarction. Issues surrounding management of anticoagulation and use of thrombolytic therapy during pregnancy are discussed. Education regarding the critical nature of adequate anticoagulation in these patients is important.
Varadarajan
Padmini
P
Division of Cardiology, Keck School of Medicine, University of Southern California, 1355 San Pablo Street, Los Angeles, CA 90033, USA.
Isaeff
Dale
D
Pai
Ramdas G
RG
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D004696:Endocarditis / Q000601:surgery; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014859:Warfarin; D006493:Heparin; D010959:Tissue Plasminogen Activator