(Ivanhoe Newswire) Young pregnant women having heart attacks may be rare
but it’s not impossible, especially for those already in high-risk categories.
Just being pregnant can triple or quadruple the risk.
“It’s 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.”
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 he’s 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
