Key result
Pregnancy increases acute myocardial infarction risk ~3-fold, most commonly driven by spontaneous coronary artery dissection.
Why the study?
Acute MI in pregnancy is not always recognised, and concerns exist regarding catheter-based interventions due to fears of foetal irradiation and risks to the foetus.
PCI is a safe and necessary life-saving procedure for pregnant women with AMI when clinically indicated, provided that specific precautions are taken to minimize fetal radiation and manage fragile coronary arteries.
May prompt earlier AMI evaluation in pregnancy; leaves open optimal PCI strategies pending prospective data.
Cardiovascular disease is the leading indirect cause of maternal mortality in the UK. Pregnancy increases the risk of acute MI (AMI) by three- to fourfold secondary to the profound physiological changes that place an extra burden on the cardiovascular system. AMI is not always recognised in pregnancy and there is concern among both clinicians and patients regarding catheter-based interventions due to fears of foetal irradiation and risks to the foetus. This article evaluates the current state of knowledge on AMI in pregnancy with particular emphasis on pregnancy-associated spontaneous coronary artery dissection and percutaneous coronary intervention as the revascularisation procedure for AMI. Special considerations that must be made in patients requiring percutaneous coronary intervention for pregnancy-associated spontaneous coronary artery dissection and the current recommendations on arterial access, methods of minimising radiation and stent selection are discussed.
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Khaing et al. (2020) conducted a review in Acute Myocardial Infarction in Pregnancy. Percutaneous Coronary Intervention was evaluated. Pregnancy increases the risk of acute myocardial infarction by three- to fourfold, with spontaneous coronary artery dissection being the most common cause, and percutaneous coronary intervention should be performed when clinically indicated.
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