Michaelis Tony, Gunaga Satheesh, McKechnie Tyson, Shafiq Qaiser
Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan.
Henry Ford Wyandotte Hospital, Department of Medicine/Division of Cardiology, Wyandotte, Michigan.
Clin Pract Cases Emerg Med. 2021 Nov;5(4):507-510. doi: 10.5811/cpcem.2021.6.52939.
Acute myocardial infarction (AMI) rarely occurs during pregnancy and presents unique challenges in diagnosis and management. Traditionally, pregnancy has not readily been considered a risk factor for AMI in the emergency department despite the potential for adverse impacts on maternal and fetal health. As cardiovascular risk factors and advanced maternal age become more prevalent in society over time, the incidence will continue to increase. Prior cases with singular gestation have been reported; however, only one previous case during a twin pregnancy was identified in the medical literature.
We describe a rare case of acute ST-segment elevation myocardial infarction in a 37-year-old woman at 24 weeks gestation with a dichorionic diamniotic twin pregnancy.
It is important for the emergency physician to recognize acute coronary syndrome as a part of the differential diagnosis of chest pain in pregnant patients and be familiar with the diagnostic and management options available for this special population.
急性心肌梗死(AMI)在孕期很少发生,在诊断和管理方面存在独特挑战。传统上,尽管对母婴健康有潜在不利影响,但在急诊科,怀孕并未被轻易视为AMI的危险因素。随着时间推移,心血管危险因素和高龄产妇在社会中变得越来越普遍,其发病率将持续上升。此前已报道过单胎妊娠的病例;然而,医学文献中仅发现一例双胎妊娠期间发生AMI的病例。
我们描述了一例罕见病例,一名37岁孕24周的双绒毛膜双羊膜囊双胎妊娠女性发生急性ST段抬高型心肌梗死。
对于急诊医生而言,认识到急性冠状动脉综合征是孕妇胸痛鉴别诊断的一部分,并熟悉针对这一特殊人群的诊断和管理选项非常重要。