Peripartum acute coronary syndrome in an otherwise healthy patient

Myocardial ischemia in pregnancy poses a significant challenge for the anesthesiologist. It is a relatively rare disorder (approximately 180 cases published in the indexed literature since 1922) but it carries high mortality. Diagnosis is frequently hampered by diminished sensitivity of several testing modalities conventionally used to diagnose myocardial ischemia. The etiology of cardiac ischemia also is multifactorial and occurs during a very dynamic period. A case of acute coronary syndrome in a parturient during urgent cesarean delivery for placental abruption is presented, followed by a brief review of the topic.