Pregnancy-related acute myocardial infarction: a review of the recent literature

Clin Res Cardiol. 2022 Jul;111(7):723-731. doi: 10.1007/s00392-021-01937-5. Epub 2021 Sep 12.

Abstract

Pregnancy-related acute myocardial infarction is a rare and potentially life-threatening cardiovascular event, the incidence of which is growing due to the heightened prevalence of several risk factors, including increased maternal age. Its main aetiology is spontaneous coronary artery dissection, which particularly occurs in pregnancy and may engender severe clinical scenarios. Therefore, despite frequently atypical and deceptive presentations, early recognition of such a dangerous complication of gestation is paramount. Notwithstanding diagnostic and therapeutic improvements, pregnancy-related acute myocardial infarction often carries unfavourable outcomes, as emergent management is difficult owing to significant limitations in the use of ionising radiation-e.g. during coronary angiography, potentially harmful to the foetus even at low doses. Notably, however, maternal mortality has steadily decreased in recent decades, indicating enhanced awareness and major medical advances in this field. In our paper, we review the recent literature on pregnancy-related acute myocardial infarction and highlight the key points in its management.

Keywords: Coronary artery dissection; Foetus; Ionising radiation; Myocardial infarction; Pregnancy.

Publication types

  • Review

MeSH terms

  • Coronary Angiography / adverse effects
  • Coronary Vessel Anomalies* / diagnosis
  • Female
  • Humans
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / etiology
  • Myocardial Infarction* / therapy
  • Pregnancy
  • Pregnancy Complications, Cardiovascular* / diagnosis
  • Pregnancy Complications, Cardiovascular* / etiology
  • Pregnancy Complications, Cardiovascular* / therapy
  • Vascular Diseases* / diagnosis