Minimum-Radiation Percutaneous Coronary Intervention for Pregnant Woman With Acute Coronary Syndrome.

Background Acute coronary syndrome during pregnancy is rare with limited evidence; management must be tailored to safeguard both mother and fetus.Case Summary A 40-year-old woman with type 2 diabetes presented with acute coronary syndrome at 11+3 weeks' gestation. She underwent intracoronary imaging-guided percutaneous coronary intervention (PCI) (3.0- × 28-mm stent, mean external elastic lamina diameter: 3.07 mm, lesion length: 28 mm) under minimal radiation (estimated fetal dose: ≈0.00004 mGy). After optimal stent implantation, 6 weeks of dual antiplatelet therapy with aspirin and clopidogrel were followed by lifelong aspirin. Pregnancy was uncomplicated with healthy infant delivered at 39 weeks. Postpartum angiography confirmed good result, and statin was initiated.Discussion Intracoronary imaging-guided PCI enables precise diagnosis and tailored therapy with reduced radiation exposure. Drug regimens balance maternal benefit and fetal safety.Take-home Messages Intracoronary imaging-guided PCI allows precise and safe treatment in pregnant ACS patients. Drug therapy must be adapted to avoid fetal risk while ensuring maternal protection.