Key result
Multidisciplinary pregnancy heart team management yields 100% maternal survival in pregnancy-related ACS cases.
Why the study?
Pregnancy-related ACS is rare and more often non-atherosclerotic, while women with a prior ACS who wish to conceive require specialized management because several cardiac medications are contraindicated and pregnancy carries clinical risk.
Cohort (n=5)
No
This single-center cohort of 5 cases highlights that non-atherosclerotic etiologies are common in pregnancy-related ACS and demonstrates that individualized care by a multidisciplinary pregnancy heart team can achieve favorable maternal and fetal outcomes.
Answers are grounded in this paper and cite their sources.
Supports multidisciplinary pregnancy heart teams for rare ACS; leaves open generalizability beyond small single-center cohorts.
Although acute coronary syndromes (ACS) occur 3–4 times more in pregnant compared to non-pregnant women, pregnancy-related ACS remain rare. The underlying pathophysiological mechanism is more often non-atherosclerotic. Women with a history of ACS who want to become pregnant need special care because several drugs are contra-indicated during pregnancy and pregnancy after ACS is not without risk. Single centre cohort study (2010–2020) of ACS cases before and during pregnancy or early (<1 month) after delivery in a 1.000 bed tertiary care centre. Multidisciplinary management and outcome of five cases are described: two cases of pregnancy after STEMI, a case of NSTEMI at the end of pregnancy and two cases of STEMI early after delivery. Patients with a history of ACS should be carefully evaluated and counseled before pregnancy. Pregnant patients with a history of ACS and patients who develop ACS during pregnancy require an individualized multidisciplinary approach.
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Gevaert et al. (2021) conducted a cohort in Acute coronary syndrome before, during, or within 1 month after pregnancy (n=5). Individualized multidisciplinary pregnancy heart team management and acute coronary syndrome occurrence around pregnancy was evaluated on Maternal and fetal survival and clinical outcomes. Multidisciplinary pregnancy heart team management of 5 ACS cases around pregnancy resulted in 100% maternal survival (5/5) and 80% live births (4/5).
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