Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK.
Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Heart. 2019 Feb;105(3):189-195. doi: 10.1136/heartjnl-2018-313454. Epub 2018 Nov 15.
Although ischaemic heart disease is currently rarely encountered in pregnancy, occurring between 2.8 and 6.2 per 100 000 deliveries, it is becoming more common as women delay becoming pregnant until later life, when medical comorbidities are more common, and because of the higher prevalence of obesity in the pregnant population. In addition, chronic inflammatory diseases, which are more common in women, may contribute to greater rates of acute myocardial infarction (AMI). Pregnancy itself seems to be a risk factor for AMI, although the exact mechanisms are not clear. AMI in pregnancy should be investigated in the same manner as in the non-pregnant population, not allowing for delays, with investigations being conducted as they would outside of pregnancy. Maternal morbidity following AMI is high as a result of increased rates of heart failure, arrhythmia and cardiogenic shock. Delivery in women with history of AMI should be typically guided by obstetric indications not cardiac ones.
虽然目前在妊娠期间很少发生缺血性心脏病，每 10 万分娩中发生 2.8 至 6.2 例，但随着女性延迟生育至更晚的年龄，当合并症更为常见时，以及由于妊娠人群中肥胖症的患病率较高，这种疾病变得更加常见。此外，在女性中更为常见的慢性炎症性疾病可能导致急性心肌梗死 (AMI) 的发生率更高。尽管确切的机制尚不清楚，但妊娠本身似乎是 AMI 的一个危险因素。对于妊娠期间的 AMI，应按照与非妊娠人群相同的方式进行调查，不应延误，应在妊娠期间之外进行调查。由于心力衰竭、心律失常和心源性休克的发生率增加，AMI 后产妇的发病率很高。对于有 AMI 病史的女性，分娩通常应根据产科指征而不是心脏指征来指导。
