Department of Nephrology/Hypertension, University of Bern, Berne, Switzerland.
Thromb J. 2010 Jun 17;8:12. doi: 10.1186/1477-9560-8-12.
Normal pregnancy corresponds to a procoagulant state. Acute myocardial infarction during pregnancy is rare, yet considering the low non-pregnant risk score of childbearing women it is still surprisingly frequent. We report a case of postpartum recurrent non-ST elevation myocardial infarction in a 40-year-old caucasian woman with essential thrombocythaemia in the presence of a positive JAK-2 mutation and an elevated anti-cardiolipin IgM antibody titer. In the majority of cases of myocardial infarction in pregnancy or in the peripartal period, atherosclerosis, a thrombus or coronary artery dissection is observed. The combination of essential thrombocythaemia and elevated anti-cardiolipin IgM antibody titer in the presence of several cardiovascular risk factors seems to be causative in our case. In conclusion, with the continuing trend of childbearing at older ages, rare or unlikely conditions leading to severe events such as myocardial infarction must be considered in pregnant women.
正常妊娠对应于一种促凝状态。妊娠期间发生急性心肌梗死很少见，但鉴于生育期妇女的非妊娠低风险评分，它仍然相当频繁。我们报告了一例 40 岁高加索裔女性的病例，她患有特发性血小板增多症，存在 JAK-2 突变阳性和抗心磷脂 IgM 抗体滴度升高，产后复发非 ST 段抬高型心肌梗死。在大多数妊娠或围产期心肌梗死的病例中，观察到动脉粥样硬化、血栓形成或冠状动脉夹层。在存在多种心血管危险因素的情况下，特发性血小板增多症和抗心磷脂 IgM 抗体滴度升高似乎是导致我们病例的原因。总之，随着生育年龄的持续增长，在孕妇中必须考虑导致严重事件（如心肌梗死）的罕见或不太可能的情况。
