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(Ivanhoe Newswire) Young pregnant women having heart attacks may be rare but its not impossible, especially for those already in high-risk categories. Just being pregnant can triple or quadruple the risk.
Its extremely important that physicians who take care of women during pregnancy and after delivery be aware of the occasional occurrence, says Uri Elkayam, M.D., a professor of Medicine and Obstetrics and Gynecology at the University of South California. Two patients need to be treated, the mother and the baby.
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Elkayam and Ari Roth, M.D., Tel Aviv University in Israel, are authors of a new study with recommendations on treatment of myocardial infarction (AMI) during and directly after pregnancy. They point out standard tests and medications like ACE inhibitors and angiostensin II receptor blockers like warfarin can be harmful to a baby, even when hes breast feeding. Information about other drugs and treatments like antiplatelet therapy and devices like drug eluding stents is also limited.
The mechanism of ARI in pregnant women can also be different. Their study showed one in four women who had a heart attack had a weakening and separation of the walls of coronary arteries, which is rare in the general population according to Elkayam. He also said 13 percent of the pregnant ARI women had normal coronary arteries. These findings signify the need to establish the cause of AMI in pregnancy in order to decide on appropriate therapy.
Elkayam and Roth first reported on this problem in 1995 when the maternal death rate from heart attacks was as high as 40 percent. Today, numbers dropped to between five and ten percent. They believe the improvement is due to awareness and more aggressive clinical treatment in general.
SOURCE: Journal of the American College of Cardiology, July 15, 2008
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