Marfan Syndrome Associated With Acute Myocardial Infarction in the First Trimester of Pregnancy

Abstract

Marfan syndrome (MFS) is a rare hereditary connective tissue disorder with autosomal dominant inheritance associated with an increased risk of cardiovascular complications due to connective tissue fragility. Acute myocardial infarction during pregnancy is also a rare event associated with poor maternal and fetal outcomes. Herein, we report a case of a 30-year-old pregnant woman with a known history of MFS. The patient had been treated surgically for an ascending aorta aneurysm and mechanical prosthetic aortic valve repair. She presented at 12 weeks of gestation with severe chest pain, which proved to be acute myocardial infarction. This is believed to be the first case of this complex medical condition presented in the first trimester of pregnancy.

Keywords: acute myocardial infarction; cardiopathy in pregnancy; marfan disease; marfan's syndrome; pregnancy.

Figure 1. Twelve-lead electrocardiogram showing ST-segment elevation in leads V2-V6 and depression in leads I and aVL

aVL: augmented Vector Left.

Figure 2. (A) Angiography of the left anterior descending artery (LAD) with total occlusion of the mid-part (yellow arrow). (B) Angiography of the normal right coronary artery (RCA) and normal mechanic aortic valve function (red arrow).

Figure 3. (A) Left anterior descending artery (LAD) after first wiring (red circle). (B) Left anterior descending artery (LAD) after the first stent implantation (yellow circle). (C) Left anterior descending artery (LAD) after the second stent implantation.