Heart disease in pregnancy: Ischaemic heart disease

Coronary artery disease and in particular acute coronary syndromes in pregnancy are increasing with high risk of mortality and significant morbidity. Whilst women with atherosclerotic risk factors are at greater risk of developing problems in pregnancy, it is important to remember that women can dev...

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Bibliographic Details
Published in:Best practice & research. Clinical obstetrics & gynaecology 2014-05, Vol.28 (4), p.551-562
Main Authors: Fryearson, John, MBChB, MRCP, Adamson, Dawn L., BSc (Hons), MBBS, MRCP, PhD
Format: Article
Language:English
Subjects:
cardiovascular pregnancy complications
Coronary Angiography
Coronary Artery Bypass
Female
Humans
myocardial ischaemia
Myocardial Ischemia - diagnosis
Myocardial Ischemia - epidemiology
Myocardial Ischemia - etiology
Myocardial Ischemia - therapy
Obstetrics and Gynecology
Pregnancy
Pregnancy Complications, Cardiovascular - diagnosis
Pregnancy Complications, Cardiovascular - epidemiology
Pregnancy Complications, Cardiovascular - etiology
Pregnancy Complications, Cardiovascular - therapy
Risk Factors
Stents
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Summary:Coronary artery disease and in particular acute coronary syndromes in pregnancy are increasing with high risk of mortality and significant morbidity. Whilst women with atherosclerotic risk factors are at greater risk of developing problems in pregnancy, it is important to remember that women can develop problems even in the absence of atherosclerosis—secondary to thrombosis or coronary dissection. A low threshold to investigate women with chest pain is paramount, and women with raised troponin levels should be investigated seriously. Acute coronary syndromes should be managed using an invasive strategy where possible and women should not have coronary angiography withheld for fear of foetal harm. This article aims to review the limited available data of coronary artery disease in pregnancy and give practical advice on the management of stable and acute coronary disease, with particular emphasis on the latter.
ISSN:1521-6934
1532-1932
DOI:10.1016/j.bpobgyn.2014.03.011