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Review
. 2022 Jun 23;9(7):198.
doi: 10.3390/jcdd9070198.

Acute Coronary Syndrome in Pregnancy and the Post-Partum Period

Affiliations
Review

Acute Coronary Syndrome in Pregnancy and the Post-Partum Period

Anna C O'Kelly et al. J Cardiovasc Dev Dis. .

Abstract

Cardiovascular disease is the leading cause of maternal mortality in the United States. Acute coronary syndrome (ACS) is more common in pregnant women than in non-pregnant controls and contributes to the burden of maternal mortality. This review highlights numerous etiologies of chest discomfort during pregnancy, as well as risk factors and causes of ACS during pregnancy. It focuses on the evaluation and management of ACS during pregnancy and the post-partum period, including considerations when deciding between invasive and non-invasive ischemic evaluations. It also focuses specifically on the management of post-myocardial infarction complications, including shock, and outlines the role of mechanical circulatory support, including veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Finally, it offers additional recommendations for navigating delivery in women who experienced pregnancy-associated myocardial infarction and considerations for the post-partum patient who develops ACS.

Keywords: acute coronary syndrome; cardio-obstetrics team; pregnancy-associated myocardial infarction; shock.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Society for Cardiovascular Angiography & Interventions (SCAI) Shock Classification Checklist for the assessment of cardiogenic shock [59].

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