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妊娠相关性急性心肌梗死(PAMI):病例报告。

Pregnancy-associated Acute Myocardial Infarction (PAMI): Case Report.

机构信息

Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.

Cardiology Unit, Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.

出版信息

West Afr J Med. 2021 Jun 26;38(6):596-598.

Abstract

Cardiovascular diseases are recognised complications of pregnancy, however, pregnancy-associated acute myocardial infarction (PAMI) is uncommon. Pregnancy is known to increase risk of myocardial infarction even in the absence of traditional risk factors for atherosclerotic vascular disease. Our patient presented with acute chest pain two weeks after delivery and her electrocardiogram was in keeping with STelevation myocardial infarction (STEMI). Coronary angiography revealed coronary artery dissection and she was managed conservatively. Various pathophysiological mechanisms of PAMI have been described in literature including spontaneous coronary artery dissection (SCAD) found in our case. The diagnosis is often missed and earlier reported cases were diagnosed at autopsy. Therefore, we report this case as a learning tool. Also, there is a need for a high index of suspicion in pregnant patients presenting with features suggestive of aortic dissection, and its diagnosis should be thought of in peripartum women presenting with acute chest pain.

摘要

心血管疾病是妊娠的公认并发症,但妊娠相关性急性心肌梗死(PAMI)并不常见。即使在没有动脉粥样硬化性血管疾病传统危险因素的情况下,妊娠也已知会增加心肌梗死的风险。我们的患者在分娩后两周出现急性胸痛,其心电图符合 ST 段抬高型心肌梗死(STEMI)。冠状动脉造影显示冠状动脉夹层,她接受了保守治疗。文献中描述了 PAMI 的各种病理生理机制,包括我们病例中发现的自发性冠状动脉夹层(SCAD)。该诊断常常被漏诊,之前报道的病例是在尸检时诊断的。因此,我们将此病例报告为学习工具。此外,对于表现出主动脉夹层特征的妊娠患者,需要高度怀疑,对于在围产期出现急性胸痛的妇女,应考虑到该病的诊断。

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