Clinical case of successful management of acute myocardial infarction during pregnancy

Introduction: There have recently been increasingly frequent reports of myocardial infarction (MI) in pregnancy and in the postpartum period. Pertinent and timely treatment affect maternal and fetal morbidity and mortality.

Clinical case: We are reporting about a 42 years old woman at the 19th week of gestation, with complains of chest pain with irradiation into the left arm, and shortness of breath. It was known from the history of present illness, that at the time of the event ventricular fibrillation was recorded and resuscitation measures with cardioversion were performed. Subsequently, after an additional examination in the hospital, a diagnosis of MI has been determined. Coronary angiography with cardiac ventriculography (CVG) has been performed and stenosis of left anterior descending coronary artery (LAD) and right coronary artery (RCA) detected. A revascularization with the insertion of the bare-metal stent system has performed and double antiplatelet therapy prescribed. At 37 weeks of gestation, the patient gave birth to a healthy child by caesarean section.

Conclusions: This clinical case illustrates the importance of minimizing the time to hospitalization of a pregnant woman with a MI to a specialized center for timely and complete diagnostic measures, which, in turn, allow to properly choose the tactics of patient management. Timely revascularization and properly selected anticoagulation are the key factors of the successful management in this category of patients.