National University Heart Centre, National University of Singapore, Singapore.
Ann Acad Med Singap. 2010 Mar;39(3):247-53.
Acute myocardial infarction (AMI) in pregnant women is a rare but potentially lethal occurrence that should be carefully managed, especially in consideration of cardiac conditions being a rising cause of maternal deaths. Risk factors for AMI occurrence, in addition to typical cardiac-related risk factors, include medical conditions such as (pre) eclampsia, blood transfusions, thrombophilia and postpartum infections. Being older, multigravida or in the third trimester of pregnancy is also associated with an increased risk. The pathophysiological causes underlying AMI in pregnancy are diverse but generally associated with the coagulative and physiological changes related to the pregnancy. The selection of diagnostic modality and treatment options require careful consideration for pregnancy-related changes as well as risk of harm to the patient and fetus. This paper serves to review available literature regarding an extensive range of management issues that directly impact on maternal and fetal outcomes.
孕妇急性心肌梗死(AMI)是一种罕见但潜在致命的疾病,应谨慎治疗,特别是考虑到心脏病是导致产妇死亡的一个上升原因。除了典型的与心脏相关的危险因素外,AMI 发生的危险因素还包括医学疾病,如(先兆)子痫、输血、血栓形成倾向和产后感染。年龄较大、多胎妊娠或妊娠晚期也与风险增加有关。妊娠相关 AMI 的病理生理学原因多种多样,但通常与妊娠相关的凝血和生理变化有关。诊断方式和治疗方案的选择需要仔细考虑与妊娠相关的变化以及对患者和胎儿造成伤害的风险。本文旨在回顾有关广泛的管理问题的现有文献,这些问题直接影响母婴结局。