Acute ST-elevation myocardial infarction in early puerperium due to severe left main coronary stenosis in a woman with familial hyperlipidaemia.
Acute myocardial infarction (AMI) is a rare but often catastrophic event during pregnancy, delivery or puerperium, leading to a high mortality rate. It has different pathogenic mechanisms, such as atherosclerosis, vasospasm, thrombosis and coronary dissection. Although MI has been reported in pregnant women at all stages of pregnancy and postpartum, it occurs more commonly in the third trimester and most commonly involves the anterior wall. Evidence suggests that pregnancy itself is an independent risk factor for MI, conferring a three- to four-fold higher risk than that of nonpregnant women matched for age, possibly due to the unique physiological changes required to meet the demands of a growing foetus. We report a case of a 27-year-old woman with familial hyperlipidaemia presenting with myocardial infarction six days after caesarean delivery, secondary to severe left main coronary stenosis (LMCA), who was treated with emergency coronary artery bypass grafting (CABG).
Cardiology Clinic, Kartal Kosuyolu Heart and Research Hospital, Cevizli-Kartal, Istanbul, Turkey.
Tahir
T
Bezgin
Ali
A
Elveran
Cem
C
Doğan
Ali
A
Karagöz
Seyhmus
S
Külahçioğlu
Gökhan
G
Kahveci
Ali
A
Metizn Esen
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D002585:Cesarean Section; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004562:Electrocardiography; D004630:Emergencies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006938:Hyperlipoproteinemia Type II / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors