Chest pain syndromes in pregnancy.
Chest pain syndromes in pregnancy include numerous catastrophic cardiovascular events. Acute myocardial infarction, aortic dissection, pulmonary embolism, and amniotic fluid embolism are the most important causes of nonobstetric mortality and morbidity in pregnancy. Each of these could result in poor maternal and fetal outcomes if not diagnosed and treated in a timely fashion. However, their diagnosis and management is limited by fetal risks of diagnostic procedures, dangers of pharmacotherapy and interventions that have neither been widely studied nor validated. This article reviews the current literature on epidemiology, risk factors, pathogenesis, diagnosis, and management of 4 potentially lethal chest pain syndromes in pregnancy.
Mount Sinai Medical Center, Cardiovascular Institute, 1 Gustave L. Levy Place, Box 1030, New York, NY 10023, USA. gagan.sahni@mountsinai.org
Gagan
G
Sahni
D000784:Aortic Dissection / Q000175:diagnosis / Q000628:therapy; D000787:Angina Pectoris / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000925:Anticoagulants / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000628:therapy; D002316:Cardiotonic Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000379:methods; D036861:Delivery, Obstetric / Q000379:methods; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D004619:Embolism, Amniotic Fluid / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D009204:Myocardial Revascularization / Q000379:methods; D016742:Preconception Care / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000379:methods; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
D000925:Anticoagulants; D002316:Cardiotonic Agents; D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; C036309:fibrin fragment D; D006493:Heparin