title: Acute myocardial infarction during pregnancy: a clinical checkmate.
abstract: Acute myocardial infarction (AMI) in pregnancy is associated with high morbidity and mortality. Management of these patients can be challenging as little is known about the optimal management strategy. Medications routinely used may have harmful effects on the pregnancy outcome. In addition, AMI could occur in the absence of atherosclerotic disease. We describe optimal management strategy by eliciting the management of a 45-year-old female with ST segment elevation myocardial infarction. We recommend early use of coronary angiography to define the pathology in such cases. Radial artery assess should be preferred. Pregnant patients with AMI due to atherosclerotic disease should be given a 325 mg of aspirin and 600 mg of clopidogrel and either balloon angioplasty or bare metal stent should be used for revascularization. Percutaneous coronary intervention with heparin is preferred over bivalirudin and later should be reserved for patients with severe heparin allergy.
authors.affiliation: New York Hospital Queens, Weill Medical College of Cornell University, New York 11355, USA. Electronic address: jais.abhishek@gmail.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Jaiswal
authors.forename: Mahjabeen
authors.initials: M
authors.lastname: Rashid
authors.forename: Mark
authors.initials: M
authors.lastname: Balek
authors.forename: Chong
authors.initials: C
authors.lastname: Park
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D002585:Cesarean Section; D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D010092:Oximetry; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000628:therapy*; D015607:Stents; D017131:Thrombectomy
chemical_list: D000925:Anticoagulants; D004232:Diuretics; D010975:Platelet Aggregation Inhibitors
keywords: Acute myocardial infarction in pregnancy; Atherosclerotic heart disease in pregnancy; Coronary dissection in pregnancy