Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4294
Peer-review started: January 14, 2021
First decision: March 8, 2021
Revised: March 16, 2021
Accepted: April 20, 2021
Article in press: April 20, 2021
Published online: June 16, 2021
Processing time: 132 Days and 5.1 Hours
Acute myocardial infarction (AMI) during pregnancy is rare, especially in twin pregnancy, and it can endanger the lives of the mother and children. Except for conventional cardiovascular risk factors, pregnancy and assisted reproduction can increase the risk of AMI during pregnancy. AMI develops secondary to different etiologies, such as coronary spasm and spontaneous coronary artery dissection.
A 33-year-old woman, with twin pregnancy in the 31st week of gestation, presented to the hospital with intermittent chest tightness for 12 wk, aggravation for 1 wk, and chest pain for 4 h. Combined with the electrocardiogram and hypersensitive troponin results, she was diagnosed with acute ST-elevation myocardial infarction. Although the patient had no related medical history, she presented several risk factors, such as age greater than 30 years, assisted reproduction, and hyperlipidemia. After diagnosis, the patient received antiplatelet and anticoagulant treatment. Cesarean section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary artery. After receiving medication, the patient was in good condition.
This case suggests that, with the widespread use of assisted reproductive technology, more attention should be paid to perinatal healthcare, especially when chest pain occurs, to facilitate early diagnosis and intervention of AMI, and the etiology of AMI in pregnancy needs to be differentiated, especially between coronary spasm and spontaneous coronary artery dissection.
Core Tip: Acute myocardial infarction (AMI) during pregnancy is rare, especially in twin pregnancy. Pregnancy and assisted reproduction can increase the risk of AMI. AMI develops secondary to different etiologies, such as spontaneous coronary artery dissection. Herein, we present a case of AMI in a 33-year-old woman with twin pregnancy in the 31st week of gestation. She presented several risk factors, such as advanced age, assisted reproduction, and hyperlipidemia. The case suggests that more attention should be paid to perinatal healthcare, especially when chest pain occurs, and the etiology of AMI in pregnancy needs to be differentiated.