Management of Acute Coronary Syndrome in Pregnancy

The incidence of coronary artery disease (CAD) in women of child-bearing age is low, and acute myocardial infarction (AMI) is uncommon.But can be devastating for both the mother and the fetus. With increased the pregnancy rate in woman older than than 40 years AMI increased in these women. There have been major advances in the diagnosis and treatment of acute coronary syndromes (ACS) in the general population, but there is little consensus on the approach to diagnosis and treatment of pregnant women. In this review we will discuss the pathophysiology, presentation, diagnosis and management of pregnant women with ACS. The risk factors for CAD is identical to general populations with added risk of hypercoagulabe state of pregnancy.In most studies coronary artery dissection is more common and atherosclerotic cacses are less frequent.Anterior MI is more common than inferior one. The presentation is identical to other patients with MI also dyspnea, nausea and cardiac arrest may be seen. More than two third of patient presentation is ST elevation MI and rest of them is non-STE MI.Diagnosis is based on symptoms, ECG and typical rise and falling of cardiac biomarkers.Management of AMI in pregnancy are the same as general population with thrombolysis, PCI and CABG on base of appropraitness.