title: Peripartum cardiac chest pain and troponin rise.
abstract: The incidence of myocardial ischaemia is increasing in the obstetric population. This has been attributed to several factors including greater maternal age, the increasing incidence of obesity and diabetes, and the growing population of patients with grown-up congenital heart disease who now reach adulthood and become pregnant. A number of cases of myocardial ischaemia in pregnant women have been documented, during and after delivery, for which no cause has been established. We present a case of a nulliparous woman who developed cardiac chest pain, bradycardia, hypertension and a raised troponin I after vaginal delivery of twin boys at 36 weeks of gestation. Ischaemic electrocardiogram changes were noted. Detailed investigations demonstrated a normal coronary circulation. A patent foramen ovale was found on bubble echocardiography.
authors.affiliation: Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Tatham
authors.forename: Y
authors.initials: Y
authors.lastname: Hughes-Roberts
authors.forename: S
authors.initials: S
authors.lastname: Davies
authors.forename: M
authors.initials: M
authors.lastname: Johnson
authors.forename: K
authors.initials: K
authors.lastname: Ashpole
authors.forename: M
authors.initials: M
authors.lastname: Cox
mesh_terms: D000328:Adult; D002637:Chest Pain / Q000209:etiology* / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D058725:Peripartum Period / Q000502:physiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D014336:Troponin / Q000097:blood*; D014429:Twins, Dizygotic; D014636:Valsalva Maneuver
chemical_list: D014336:Troponin