title: Acute myocardial infarction in the puerperium.
abstract: The authors describe the case of a forty-two-year-old patient with acute myocardial infarction (MI) on the third day of puerperium, who underwent direct angioplasty. The authors review the main physiological cardiovascular and hemostatic changes in pregnancy, which are usually well tolerated but which increase the probability of cardiovascular events when risk factors or previous cardiac disease are associated. Blood volume and cardiac output increase by around 50% during pregnancy, hemoglobin concentration falls, and reduced peripheral vascular resistance leads to a fall in arterial blood pressure during the first half of pregnancy. End-diastolic pressure, stroke volume and cardiac output increase in the immediate puerperium, and cardiovascular risk is highest in the perinatal period. The incidence of MI during pregnancy and puerperium is low; however, it is on the increase due to the growing number of pregnancies in women close to the end of their reproductive age.
authors.affiliation: Serviço de Medicina Materno-Fetal da Maternidade Dr. Alfredo da Costa, Lisboa, Portugal. jmlreis@netcabo.pt
authors.forename: José Lourenço
authors.initials: JL
authors.lastname: Reis
authors.forename: Lisa
authors.initials: L
authors.lastname: Vicente
authors.forename: Francisca
authors.initials: F
authors.lastname: Aleixo
authors.forename: Tiago
authors.initials: T
authors.lastname: Rocha
authors.forename: Lino
authors.initials: L
authors.lastname: Patrício
authors.forename: Augusta
authors.initials: A
authors.lastname: Borges
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis; D011644:Puerperal Disorders / Q000175:diagnosis