scholarly journals Pregnancy-related acute myocardial infarction: a review of the recent literature

2021 ◽  
Author(s):  
Andrea Carlo Merlo ◽  
Gian Marco Rosa ◽  
Italo Porto
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Recent Literature ◽  
Early Recognition ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Clinical Scenarios ◽  
Key Points ◽  
Life Threatening ◽  
Medical Advances

AbstractPregnancy-related acute myocardial infarction is a rare and potentially life-threatening cardiovascular event, the incidence of which is growing due to the heightened prevalence of several risk factors, including increased maternal age. Its main aetiology is spontaneous coronary artery dissection, which particularly occurs in pregnancy and may engender severe clinical scenarios. Therefore, despite frequently atypical and deceptive presentations, early recognition of such a dangerous complication of gestation is paramount. Notwithstanding diagnostic and therapeutic improvements, pregnancy-related acute myocardial infarction often carries unfavourable outcomes, as emergent management is difficult owing to significant limitations in the use of ionising radiation—e.g. during coronary angiography, potentially harmful to the foetus even at low doses. Notably, however, maternal mortality has steadily decreased in recent decades, indicating enhanced awareness and major medical advances in this field. In our paper, we review the recent literature on pregnancy-related acute myocardial infarction and highlight the key points in its management.

Recognition of acute myocardial infarction caused by spontaneous coronary artery dissection of first septal perforator

2021 ◽  
Author(s):  
Scott W Sharkey ◽  
Mesfer Alfadhel ◽  
Christina Thaler ◽  
David Lin ◽  
Meagan Nowariak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Invasive Coronary Angiography ◽  
Acute Chest Pain ◽  
Vancouver General Hospital ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Septal Perforator

Abstract Aims  Spontaneous coronary artery dissection (SCAD) diagnosis is challenging as angiographic findings are often subtle and differ from coronary atherosclerosis. Herein, we describe characteristics of patients with acute myocardial infarction (MI) caused by first septal perforator (S1) SCAD. Methods and results  Patients were gathered from SCAD registries at Minneapolis Heart Institute and Vancouver General Hospital. First septal perforator SCAD prevalence was 11 of 1490 (0.7%). Among 11 patients, age range was 38–64 years, 9 (82%) were female. Each presented with acute chest pain, troponin elevation, and non-ST-elevation MI diagnosis. Initial electrocardiogram demonstrated ischaemia in 5 (45%); septal wall motion abnormality was present in 4 (36%). Angiographic type 2 SCAD was present in 7 (64%) patients with S1 TIMI 3 flow in 7 (64%) and TIMI 0 flow in 2 (18%). Initial angiographic interpretation failed to recognize S1-SCAD in 6 (55%) patients (no culprit, n = 5, septal embolism, n = 1). First septal perforator SCAD diagnosis was established by review of initial coronary angiogram consequent to cardiovascular magnetic resonance (CMR) demonstrating focal septal late gadolinium enhancement with corresponding oedema (n = 3), occurrence of subsequent SCAD event (n = 2), or second angiogram showing healed S1-SCAD (n = 1). Patients were treated conservatively, each with ejection fraction >50%. Conclusion  First septal perforator SCAD events may be overlooked at initial angiography and mis-diagnosed as ‘no culprit’ MI. First septal perforator SCAD prevalence is likely greater than reported herein and dependent on local expertise and availability of CMR imaging. Spontaneous coronary artery dissection events may occur in intra-myocardial coronary arteries, approaching the resolution limits of invasive coronary angiography.

A rare cause of chest pain in paediatric age: a teenager with acute myocardial infarction due to spontaneous coronary artery dissection

2022 ◽  
Vol 15 (1) ◽  
pp. e246393
Author(s):  
Filipa Costa Cascais ◽  
Ana Rita Pereira ◽  
Ana Rita Almeida ◽  
Luísa Rocha
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Coronary Artery ◽  
Invasive Coronary Angiography ◽  
Warning Signs ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Paediatric Age ◽  
Life Threatening

A healthy 17-year-old boy was admitted to the emergency department presenting with a pressure-like sternal pain that started during exercise. His physical examination was normal. Twelve-lead ECG and transthoracic echocardiogram suggested a myocardial infarction. The patient was submitted to an invasive coronary angiography, which revealed a distal occlusion of the left anterior descending artery, due to a spontaneous coronary artery dissection. A balloon angioplasty was performed, with good results. Aetiological study did not discover any pathologic condition. Chest pain in paediatric age is a frequent complaint, despite not being usually caused by a serious condition. However, it is important to remember warning signs in order to diagnose life-threatening diseases, as soon as possible.

CARDIOVASCULAR DISEASES: PREVALENCE, RISK FACTORS (LITERATURE REVIEW)

Vestnik ◽  
2021 ◽  
pp. 84-92
Author(s):  
М.О. Мустафина ◽  
А. Телжанов ◽  
З.Н. Лигай
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Young Patients ◽  
Microvascular Dysfunction ◽  
Artery Dissection ◽  
Variant Angina ◽  
Coronary Artery Dissection ◽  
Plaque Erosion

Мы провели поиск в PubMed статей, опубликованных с 1980 по 2020, используя термины «острый инфаркт миокарда», «молодой», «разрыв бляшки», эрозия бляшки, спонтанное расслоение коронарной артерии (SCAD), коронарный вазоспазм», «вариантная стенокардия или стенокардия Принцметала», «лекарственный инфаркт миокарда», «миокардит», «коронарная эмболия», «микрососудистая дисфункция», «MINOCA», а также обзор всех опубликованных исследований. Используя данные этого поиска, мы стремимся проинформировать читателей о распространенности, факторах риска, проявлениях и лечении острого инфаркта миокарда у молодых пациентов, а также подробно рассказать о специальных подгруппах с диагностическими и терапевтическими проблемами. We searched PubMed for articles published from 1980 to 2020 using the terms acute myocardial infarction, young, plaque rupture, plaque erosion, spontaneous coronary artery dissection (SCAD), coronary vasospasm, variant angina or angina pectoris. Prinzmetal, drug myocardial infarction, myocarditis, coronary embolism, microvascular dysfunction, MINOCA, and a review of all published studies. Using the data from this search, we aim to inform readers about the prevalence, risk factors, manifestations and treatment of acute myocardial infarction in young patients, as well as detail the special subgroups with diagnostic and therapeutic problems.

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