Thorp J M, Chescheir N C, Fann B
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill 27514.
Am J Perinatol. 1994 Jan;11(1):1-3. doi: 10.1055/s-2007-994522.
Myocardial infarction in association with pregnancy in patients with the antiphospholipid syndrome has been reported once previously. Our patient, a 22-year-old multiparous woman, experienced a myocardial infarction in the postpartum period. She fulfilled the criteria for the diagnosis of the antiphospholipid syndrome (elevated anticardiolipin antibody levels, false-positive syphilis serology, history of deep vein thrombosis). Cardiac catheterization demonstrated appropriate central filling pressures, cardiac output of 7.14 L/min, and normal-appearing coronary arteries. She was treated with corticosteroids and indomethacin and recovered. Our article is relevant to clinical practice for the following reasons. First, it is the second time myocardial necrosis has been reported in a recently pregnant woman with the antiphospholipid syndrome. Second, the finding of normal-appearing coronary arteries at the time of catheterization lends credence to the hypothesis that either vasospasm or thrombosis are the inciting events. We speculate on the utility of various treatment regimens.
抗磷脂综合征患者合并妊娠并发心肌梗死此前仅有过一次报道。我们的患者是一名22岁经产妇，在产后发生了心肌梗死。她符合抗磷脂综合征的诊断标准（抗心磷脂抗体水平升高、梅毒血清学假阳性、有深静脉血栓形成病史）。心导管检查显示中心充盈压正常，心输出量为7.14 L/分钟，冠状动脉外观正常。她接受了皮质类固醇和吲哚美辛治疗并康复。我们的文章与临床实践相关，原因如下。第一，这是第二次报道近期妊娠的抗磷脂综合征女性发生心肌坏死。第二，导管检查时冠状动脉外观正常这一发现支持了血管痉挛或血栓形成是诱发事件的假说。我们推测了各种治疗方案的效用。
