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Ischaemic heart disease and pregnancy
Matthew Cauldwell1, Lucia Baris2, Jolien W Roos-Hesselink2
1Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK.
Heart (British Cardiac Society)
|November 17, 2018
Summary
Ischaemic heart disease in pregnancy is rising due to delayed childbearing and obesity. Acute myocardial infarction (AMI) during pregnancy requires prompt investigation and management similar to non-pregnant individuals.
Area of Science:
- Cardiology
- Obstetrics
- Public Health
Background:
- Ischaemic heart disease in pregnancy is increasing.
- Factors include delayed childbearing, comorbidities, and obesity.
- Chronic inflammatory diseases and pregnancy itself may increase acute myocardial infarction (AMI) risk.
Purpose of the Study:
- To review the current understanding of ischaemic heart disease in pregnancy.
- To emphasize the importance of timely diagnosis and management of AMI during pregnancy.
- To discuss maternal morbidity and delivery considerations for pregnant individuals with AMI.
Main Methods:
- Literature review of ischaemic heart disease and AMI in pregnancy.
- Analysis of risk factors, diagnostic approaches, and maternal outcomes.
- Discussion of management strategies and delivery guidance.
Main Results:
- AMI in pregnancy is becoming more prevalent.
- Pregnancy may be an independent risk factor for AMI.
- Maternal morbidity is high, including heart failure, arrhythmia, and cardiogenic shock.
- Investigations and management should not be delayed.
Conclusions:
- AMI in pregnancy necessitates prompt investigation and management comparable to non-pregnant patients.
- Delivery should be guided by obstetric, not cardiac, indications.
- Increased vigilance and timely intervention are crucial for improving maternal outcomes.
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