Acute myocardial infarction and pregnancy
- Carol A Waksmonski, MD
Carol A Waksmonski, MD
- Professor of Medicine
- Columbia University Medical Center
- Anita LaSala, MD
Anita LaSala, MD
- Assistant Professor of Obstetrics-Gynecology
- Columbia University Medical Center
- Section Editors
- Guy S Reeder, MD
Guy S Reeder, MD
- Section Editor — Coronary Disease
- Professor of Medicine
- Mayo Medical School
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
Myocardial infarction (MI) is an uncommon event in women of childbearing age. However, as the birth rate for women older than 40 years has increased in recent years in some countries such as the United States, MI in pregnant women may become more common .
Issues related to acute MI in pregnancy will be reviewed here. Other types of acquired heart disease in pregnancy, such as valvular disease and heart failure, are discussed separately. (See "Acquired heart disease and pregnancy" and "Management of heart failure during pregnancy".)
The incidence and timing of acute myocardial infarction associated with pregnancy are illustrated by the findings in two large epidemiologic studies:
●In a report from California of births between 1991 and 2000, the incidence was 2.8 per 100,000 deliveries .
●In a review from the Nationwide Inpatient Sample of pregnancy discharges between 2000 and 2002 in about 1000 hospitals in the United States, the incidence was 6.2 in 100,000 pregnancies . It was estimated the risk of MI was increased three- to fourfold compared to nonpregnant women. Possible explanations for the increased rate of MI compared to the study above include regional differences and improved detection due to widespread use of troponin testing. (See "Troponins as biomarkers of cardiac injury".)
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