Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Clin Obstet Gynecol. 2020 Dec;63(4):852-867. doi: 10.1097/GRF.0000000000000558.
Pregnancy-related maternal mortality and morbidity rates continue to increase in the United States despite global improvements in maternal outcomes. The unique hemodynamic and physiological changes of pregnancy results in a 3- to 4-fold increased risk of acute myocardial infarction (AMI) which causes a substantial proportion of all maternal cardiac deaths. In addition to atherosclerosis, pregnancy-associated AMI is commonly caused by nonatherosclerotic etiologies such as spontaneous coronary artery dissection, embolus to the coronary artery, and coronary vasospasm. Herein, the epidemiology, etiologies, presentation, diagnosis, and management of AMI in pregnancy is discussed along with future directions for multidisciplinary care.
尽管全球孕产妇结局有所改善，但美国与妊娠相关的孕产妇死亡率和发病率仍在持续上升。妊娠时独特的血液动力学和生理学变化导致急性心肌梗死（AMI）的风险增加 3 至 4 倍，这导致了相当一部分孕产妇心脏死亡。除了动脉粥样硬化，与妊娠相关的 AMI 通常还由非动脉粥样硬化病因引起，如自发性冠状动脉夹层、冠状动脉栓塞和冠状动脉痉挛。本文讨论了妊娠期间 AMI 的流行病学、病因、表现、诊断和治疗，以及多学科治疗的未来方向。
