Key result
Primary angioplasty with stenting at 32 weeks' gestation enables maternal recovery and successful term delivery.
Why the study?
Acute myocardial infarction during pregnancy is rare but carries a high mortality rate, especially during labor and delivery.
Case Report (n=1)
No
Answers are grounded in this paper and cite their sources.
Demonstrates that prompt diagnosis of STEMI during the third trimester of pregnancy managed with primary PCI, dual antiplatelet therapy (aspirin and clopidogrel), and planned cesarean delivery at term can achieve favorable maternal and fetal survival.
BACKGROUND Acute myocardial infarction during pregnancy is rare, but is associated with a high mortality rate, particularly during labor and delivery. This article concerns a 23-year-old woman with a history of insulin-treated gestational diabetes and hypothyroidism treated with levothyroxine presenting at 32 weeks of pregnancy with acute chest pain and coronary artery occlusion requiring angioplasty followed by cesarean delivery. The aim of this report is to outline the diagnostic difficulties of acute coronary syndromes during pregnancy and to present their treatment. CASE REPORT A 23-year-old female patient at 32 weeks' gestation treated for insulin-dependent diabetes mellitus and hypothyroidism was admitted to the hospital due to acute chest pain. The ECG showed ST-segment elevation in leads I, aVL, and V4-V6 and elevated troponin T. Based on this, the patient was diagnosed with myocardial infarction and given low-molecular heparin, followed by primary coronary angioplasty with revascularization. After the procedure, she received dual antiplatelet therapy (DAPT) with acetylsalicylic acid and clopidogrel. The pregnancy was terminated at 38 weeks by cesarean section, delivering a healthy baby. CONCLUSIONS This report shows the importance of rapid and accurate diagnosis and management of acute myocardial infarction during pregnancy, and delivery by cesarean section, to ensure survival of the mother and the child.
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Zieliński et al. (2023) conducted a case report in Acute ST-elevation myocardial infarction during pregnancy (n=1). Primary percutaneous coronary intervention with Onyx stent implantation, enoxaparin, dual antiplatelet therapy (acetylsalicylic acid and clopidogrel), and cesarean section was evaluated on Maternal and fetal survival and clinical recovery. Primary coronary angioplasty with stent implantation and dual antiplatelet therapy at 32 weeks' gestation enabled maternal recovery and delivery of a healthy 3260 g infant via cesarean section at 38-39 weeks.
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