title: Heart disease in pregnancy: ischaemic heart disease.
abstract: Coronary artery disease and in particular acute coronary syndromes in pregnancy are increasing with high risk of mortality and significant morbidity. Whilst women with atherosclerotic risk factors are at greater risk of developing problems in pregnancy, it is important to remember that women can develop problems even in the absence of atherosclerosis-secondary to thrombosis or coronary dissection. A low threshold to investigate women with chest pain is paramount, and women with raised troponin levels should be investigated seriously. Acute coronary syndromes should be managed using an invasive strategy where possible and women should not have coronary angiography withheld for fear of foetal harm. This article aims to review the limited available data of coronary artery disease in pregnancy and give practical advice on the management of stable and acute coronary disease, with particular emphasis on the latter.
authors.affiliation: Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. Electronic address: John.Fryearson@uhb.nhs.uk.
authors.forename: John
authors.initials: J
authors.lastname: Fryearson
authors.affiliation: University Hospital of Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK. Electronic address: Dawn.adamson@uhcw.nhs.uk.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Adamson
mesh_terms: D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D012307:Risk Factors; D015607:Stents
keywords: cardiovascular pregnancy complications; myocardial ischaemia