Diagnosis, Treatment of Heart Attack in Pregnancy Reviewed

Should be diagnosed and treated same as non-pregnant patients, but considering maternal and fetal factors

THURSDAY, July 10 (HealthDay News) -- Although rare, pregnancy-related heart attacks most often occur in women with cardiovascular risk factors and should be diagnosed and treated the same way as in non-pregnant patients while taking maternal and fetal factors into account, according to a review in the July 15 issue of the Journal of the American College of Cardiology.

Arie Roth, M.D., from Tel Aviv University Sackler School of Medicine in Israel, and Uri Elkayam, M.D., from the University of Southern California Keck School of Medicine in Los Angeles, identified 95 cases of acute myocardial infarction during or following pregnancy in the scientific literature from 1995-2005, in addition to eight cases they treated or consulted on. They note that although rare, pregnancy increases the risk of myocardial infarction three- to fourfold.

The investigators found that myocardial infarction occurs at all stages of pregnancy but in multigravidas in 66 percent of cases, that 72 percent occurred in patients over 30 years old, and that 78 percent of myocardial infarctions were in the anterior wall. Most women had risk factors such as smoking, hyperlipidemia, family histories of myocardial infarction, hypertension or diabetes. The mortality rate was 11 percent, the researchers note.

"Criteria for diagnosis of acute myocardial infarction in pregnant women are in general the same as in non-pregnant patients and consist primarily of symptoms, electrocardiographic changes and cardiac markers. At the same time, however, the diagnostic approach is also influenced by fetal safety and normal changes during pregnancy," the authors write.

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