Ischemic complications of pregnancy: Who is at risk?

Sara C. Martinez, Sharonne N. Hayes

Research output: Contribution to journalArticlepeer-review

Abstract

The physiologic demands of pregnancy may either trigger or uncover ischemic heart disease (IHD) via largely unknown mechanisms, leading to an increased mortality compared with nonpregnant individuals. Risk factors for IHD in pregnancy are age, smoking, multiparity, and prior cardiac events. A multidisciplinary team at a referral center is key to coordinating medical or invasive management and inpatient observation. Etiologies may be revealed by experienced angiographers, and are predominantly spontaneous coronary artery dissection, followed by atherosclerotic disease and thrombus, while a significant percentage of women are found to have normal coronary arteries by angiogram. The management of these conditions is varied and, in general, conservative management is preferred with adequate coronary flow and stable hemodynamics. A woman with a history of IHD in pregnancy is at a substantial risk for further complications in future pregnancies and beyond; therefore, aggressive risk factor-reduction strategies and regular cardiology follow-up are imperative to decrease adverse events.

Original languageEnglish (US)
Pages (from-to)14-20
Number of pages7
JournalUS Cardiology Review
Volume10
Issue number1
StatePublished - 2016

Keywords

  • ACS
  • Coronary artery disease
  • Coronary artery dissection
  • Myocardial infarction
  • Pregnancy
  • SCAD

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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