Myocardial infarction in pregnancy associated with a coronary artery thrombus

The case of a 36-year-old multigravid woman in whom acute myocardial infarction developed at five months post partum is described. Coronary angiography performed 11 days following myocardial infarction demonstrated a thrombus-like lesion in the coronary artery branch supplying the area of myocardial damage with no other evidence of coronary artery disease. This finding suggests that the development of a coronary artery thrombus is part of the mechanism of myocardial infarction in this case where the phenomenon of angiographically normal coronary arteries following myocardial infarction has bee- described. The mechanism leading to the development of a coronary thrombus in pregnancy is obscure, but may be similar to other clotting abnormalities complicating the third trimester and puerperium.