Firoz Tabassum, Magee Laura A
Department of Medicine, University of British Columbia , Vancouver, British Columbia, Canada.
Obstet Med. 2012 Jun;5(2):50-7. doi: 10.1258/om.2011.011080. Epub 2012 Mar 22.
Acute myocardial infraction (AMI) in the obstetric patient is a rare event, although the incidence is rising due to advancing maternal age and pre-existing cardiac risk factors and medical co-morbidities. While atherosclerotic disease is the leading cause of AMI, coronary artery dissection is an important consideration in pregnancy and in the postpartum period. The physiological changes of pregnancy as well as pregnancy-specific risk factors can predispose the obstetric patient to AMI. Diagnosis of AMI can be challenging as symptoms may be atypical. Furthermore, diagnostic tests must be interpreted in the context of pregnancy. While the overall management of the obstetric patient with AMI is similar to that outside of pregnancy, drug therapy requires modification as some medications may be contraindicated in pregnancy and breastfeeding. There is limited information about prognosis and risk stratification but it is anticipated that future studies will address this issue.
产科患者发生急性心肌梗死（AMI）是一种罕见事件，尽管由于孕产妇年龄增加、既往存在的心脏危险因素和合并症，其发病率正在上升。虽然动脉粥样硬化疾病是AMI的主要原因，但冠状动脉夹层在孕期和产后是一个重要的考虑因素。妊娠的生理变化以及特定于妊娠的危险因素可使产科患者易患AMI。AMI的诊断可能具有挑战性，因为症状可能不典型。此外，诊断检查必须结合妊娠情况进行解读。虽然患有AMI的产科患者的总体管理与非孕期相似，但药物治疗需要调整，因为某些药物在妊娠和哺乳期可能是禁忌的。关于预后和风险分层的信息有限，但预计未来的研究将解决这个问题。
