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Chapter 32 - Ischemic Heart Disease and Acute Coronary Syndrome in Pregnancy

from Section 6 - Cardiopulmonary Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Hannah Douglas ,
Amira El-Messidi  and
Anita Banerjee
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 38-year-old G7P7 is referred by her primary care provider to your high-risk obstetrics clinic for preconception consultation after having angiography and percutaneous coronary intervention (PCI) in your tertiary center for a non-ST elevation myocardial infarction (NSTEMI) 18 months ago. All her children, the youngest aged four years, were delivered vaginally at term prior to emigrating from Africa.

Keywords

Preconception counseling, ischemic heart diseasePregnancy-associated acute coronary syndromeComorbiditiesRisk factors, modifiable and nonmodifiableExaminationInvestigationsInvasive treatmentConservative managementPregnancy outcomesTicagrelorClopidogrelHeparinsIntrapartum care, obstetric deliveryMaternal cardiac hemodynamicsST-elevation myocardial infarctionPercutaneous coronary intervention, pregnancy, obstetric considerationsUnstable anginaElectrocardiogramContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 422 - 432
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Baris, L, Hakeem, A, Moe, T, et al. Acute coronary syndrome and ischemic heart disease in pregnancy: data from the EURObservational Research Programme – European Society of Cardiology Registry of Pregnancy and Cardiac Disease. J Am Heart Assoc. 2020;9(15):e015490.Google Scholar
Campbell, KH, Tweet, MS. Coronary disease in pregnancy: myocardial infarction and spontaneous coronary artery dissection. Clin Obstet Gynecol. 2020;63(4):852–867.CrossRefGoogle ScholarPubMed
Cauldwell, M, Baris, L, Roos-Hesselink, JW, et al. Ischaemic heart disease and pregnancy. Heart. 2019;105(3):189–195.CrossRefGoogle ScholarPubMed
Chavez, P, Wolfe, D, Bortnick, AE. Management of ischemic heart disease in pregnancy. Curr Atheroscler Rep. 2021;23(9):52.CrossRefGoogle ScholarPubMed
Lameijer, H, Burchill, LJ, Baris, L, et al. Pregnancy in women with pre-existent ischaemic heart disease: a systematic review with individualised patient data. Heart. 2019;105(11):873–880.Google Scholar
Nallapati, C, Park, K. Ischemic heart disease in pregnancy. Cardiol Clin. 2021;39(1):91–108.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (NICE): Intrapartum care for women with existing medical conditions or obstetric complications and their babies. Evidence reviews for women at high risk of adverse outcomes for themselves and/or their baby because of existing maternal medical conditions, September 2018. Available at www.nice.org.uk/guidance/ng121/documents/evidence-review-14. Accessed July 18, 2021.Google Scholar
Park, K, Bairey Merz, CN, Bello, NA, et al. Management of women with acquired cardiovascular disease from pre-conception through pregnancy and postpartum: JACC Focus Seminar 3/5. J Am Coll Cardiol. 2021;77(14):1799–1812.Google Scholar
Regitz-Zagrosek, V, Roos-Hesselink, JW, Bauersachs, J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39(34):3165–3241.Google Scholar
Tweet, MS, Lewey, J, Smilowitz, NR, et al. Pregnancy-associated myocardial infarction: prevalence, causes, and interventional management. Circ Cardiovasc Interv. 2020. https://doi.org/10.1161/CIRCINTERVENTIONS.120.008687Google Scholar

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