Case 02 (2024): Acute ST-segment elevation myocardial infarction during pregnancy caused by coronary artery dissection: a case report
10.3760/cma.j.cn113903-20240204-00062
- VernacularTitle:病例02（2024）：冠状动脉夹层致妊娠期急性ST段抬高型心肌梗死1例
- Author:
Lingying KONG
1
;
Pengkang HE
;
Jianping LI
;
Dongxin WANG
;
Tao HONG
;
Yu SUN
;
Qian CHEN
;
Yumei WEI
;
Hong ZHANG
;
Huixia YANG
Author Information
1. 北京大学第一医院妇产生殖医学中心，北京 100034
- Keywords:
Coronary artery dissection;
ST-segment elevation myocardial infarction;
Pregnancy;
Third trimester
- From:
Chinese Journal of Perinatal Medicine
2024;27(3):226-232
- CountryChina
- Language:Chinese
-
Abstract:
This article presents a case of acute ST-segment elevation myocardial infarction (STEMI) in a pregnant woman caused by coronary artery dissection. The 41-year-old patient had undergone cardiac valve surgery at the age of 1 and had no risk factors such as hypertension, diabetes, smoking, alcohol use, or a family history of coronary artery disease. At 31 +1 weeks of gestation, she experienced sudden chest pain for 4 hours and was emergently referred to Peking University First Hospital on June 1, 2021. Electrocardiogram revealed ST-segment elevation in leads I, aVL, and V 2 to V 6. Biochemical assays showed elevated levels of high-sensitivity cardiac troponin I and creatine kinase-MB. Echocardiography indicated segmental ventricular wall motion abnormalities (apical) and reduced left ventricular function, confirming the diagnosis of acute anterior wall STEMI. The patient promptly underwent emergency coronary angiography and percutaneous coronary intervention and confirmed coronary artery dissection. Postoperative care included antiplatelet, anticoagulation, and supportive treatment. At 34 +3 weeks of gestation, with the condition of acute anterior wall STEMI being relatively stable, a cesarean section was successfully performed. Regular cardiology follow-ups were scheduled postpartum, and cardiac function was normal in two years after discharge.
