Archives of the Turkish Society of Cardiology
Acute Anterior Myocardial Infarction in the 36th week of Pregnancy: Successful Stepwise Treatment Approach [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-79092

Acute Anterior Myocardial Infarction in the 36th week of Pregnancy: Successful Stepwise Treatment Approach

Murat Akçay, Murat Meriç, Ömer Gedikli, Serkan Yüksel, Mahmut Şahin
Ondokuz Mayıs University Faculty of Medicine, Department of Cardiology, Samsun, Turkey

Acute myocardial infarction (AMI) is associated with a high incidence of maternal and fetal complications when develops in pregnancy and early postpartum period. Pathophysiology involves different factors including alterations in the vascular wall and hypercoagulability resulting from the hormonal and hemodynamic effects of pregnancy. It results frequently from the development of thrombus on ruptured plaque. In addition, coronary artery dissection constitutes a significant cause in pregnancy. In literature, the therapeutic approach covers a wide spectrum ranging from the conservative follow-up to percutaneous coronary intervention and urgent bypass surgery and rarely thrombolytic therapy. Maternal and fetal complications are seen more frequently during invasive interventions and bypass surgeries because of the structural changes in coronary intima and media wall, so the success rate is low. In this case report; we present a 36th week pregnant woman who presented with acute anterior myocardial infarction in whom the occlusion could not be detected in primary percutaneous intervention, so thrombolytic treatment and stepwise percutaneous intervention were performed.

Keywords: Acute myocardial infarction, Pregnancy, Spontaneous coronary artery dissection, Stepwise treatment approach

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Corresponding Author: Murat Akçay, Türkiye
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