Key result
Routine antenatal echocardiographic screening can uncover silent MI in pregnancy.
Why the study?
Cardiovascular evaluation in pregnancy is crucial, particularly in resource-limited settings, where high clinical suspicion is key to timely diagnosis and management to improve maternal and fetal outcomes.
Case Report (n=1)
This case highlights the diagnostic complexity of pregnancy-associated myocardial infarction and the utility of multimodal imaging for timely diagnosis.
May warrant routine antenatal echo with high suspicion for silent MI; hypothesis-generating and should not yet alter practice.
BACKGROUND: Pregnancy-associated myocardial infarction (PAMI) is a rare but potentially life-threatening condition with significant fetomaternal implications. CASE SUMMARY: A 22-year-old primigravida at 27 weeks of gestation was incidentally found to have left ventricular apical akinesia during echocardiographic screening. Cardiac magnetic resonance imaging confirmed an infarct in the territory of the left anterior descending artery, and coronary computed tomography angiography at 80 days after the event showed nonobstructive coronaries, suggesting a healed spontaneous coronary artery dissection or resolved thrombus. The patient was managed medically but experienced fetal demise at 28 weeks of gestation. DISCUSSION: PAMI differs from myocardial infarction in the general population. Spontaneous coronary artery dissection is the leading cause during pregnancy, followed by atherosclerosis. This case highlights the diagnostic complexity of PAMI and underscores the value of multimodal imaging in pregnant patients presenting with cardiac symptoms. TAKE-HOME MESSAGES: Cardiovascular evaluation in pregnancy is crucial, particularly in resource-limited settings. A high clinical suspicion is key to timely diagnosis and appropriate management to improve maternal and fetal outcomes.
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Fayyaz et al. (2026) conducted a case report in Pregnancy-associated myocardial infarction (PAMI) (n=1). Multimodal imaging and medical management was evaluated. Multimodal imaging uncovered a silent myocardial infarction in a 22-year-old pregnant woman during routine screening, though she subsequently experienced fetal demise at 28 weeks of gestation.
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