Shahabi Shohreh, Smith Nicole A, Chanana Charu, Abbott J Dawn, Copel Joshua, Setaro John F
Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA.
Ups J Med Sci. 2008;113(3):325-30. doi: 10.3109/2000-1967-239.
Myocardial infarction in pregnancy carries high morbidity. Spontaneous coronary artery dissection is one etiology of infarction, and up to one third of cases may arise in the third trimester of pregnancy or within three months postpartum.
We report two cases of spontaneous coronary artery dissection, one at 34 weeks gestation and one postpartum. Both patients were diagnosed with angiography and treated medically and one required percutaneous coronary intervention, with good obstetric outcome and return of cardiac function.
Myocardial infarction, and particularly spontaneous coronary artery dissection, should be in the differential diagnosis of pregnant women presenting with cardiac-type symptoms, despite perceived lack of risk factors. Angiography will aid in diagnosis, and multiple therapeutic modalities exist.
妊娠期心肌梗死发病率高。自发性冠状动脉夹层是梗死的病因之一，高达三分之一的病例可能发生在妊娠晚期或产后三个月内。
我们报告两例自发性冠状动脉夹层病例，一例发生在妊娠34周时，另一例发生在产后。两名患者均通过血管造影确诊，并接受了药物治疗，其中一名患者需要进行经皮冠状动脉介入治疗，产科结局良好，心功能恢复。
尽管认为缺乏危险因素，但心肌梗死，尤其是自发性冠状动脉夹层，应列入出现心脏型症状的孕妇的鉴别诊断中。血管造影有助于诊断，且存在多种治疗方式。
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