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妊娠期急性心肌梗死:当前的诊断与管理方法

Acute myocardial infarction in pregnancy: Current diagnosis and management approaches.

作者信息

Edupuganti Mohan M, Ganga Vyjayanthi

机构信息

Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, USA.

Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, USA.

出版信息

Indian Heart J. 2019 Sep-Oct;71(5):367-374. doi: 10.1016/j.ihj.2019.12.003. Epub 2019 Dec 17.

Abstract

Acute myocardial infarction during pregnancy is a very uncommon condition; atherosclerotic coronary artery disease is by far the most common cause of an acute coronary syndrome in the general population. The causes of an acute coronary syndrome in the pregnant patient are wide and varied. This has important implications with respect to the diagnosis of the etiology and the subsequent management of the cause of the acute coronary syndrome. There are a number of diagnostic tools for the diagnosis of coronary artery disease but it is important to understand their role in pregnant patients. Spontaneous coronary artery dissection is one of the most common causes of acute coronary syndrome in pregnant patients. Understanding its pathophysiology and knowing the natural history of this condition is paramount in the management of this condition. The article also lists the various therapeutic modalities available to the clinician faced with an acute coronary syndrome in the pregnant patient. Finally, we discuss the delivery of the baby and post partum care of these complex patients.

摘要

妊娠期急性心肌梗死是一种非常罕见的病症;在普通人群中,动脉粥样硬化性冠状动脉疾病是急性冠状动脉综合征最常见的病因。妊娠患者发生急性冠状动脉综合征的原因广泛且多样。这对于急性冠状动脉综合征病因的诊断及后续病因管理具有重要意义。有多种诊断工具可用于诊断冠状动脉疾病,但了解它们在妊娠患者中的作用很重要。自发性冠状动脉夹层是妊娠患者急性冠状动脉综合征最常见的病因之一。了解其病理生理学并知晓该病症的自然病程对于管理该病症至关重要。本文还列出了临床医生在面对妊娠患者急性冠状动脉综合征时可用的各种治疗方式。最后,我们讨论了这些复杂患者的分娩及产后护理。

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