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Journal of Education, Health and Sport

Sudden cardiac arrest as a result of anterior and lateral myocardial infarction at 16 weeks of gestation - case report
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Sudden cardiac arrest as a result of anterior and lateral myocardial infarction at 16 weeks of gestation - case report

Authors

  • Justyna Wojcik Student's Scientific Association at the Chair and Department of Perinatology and Obstetrics, Medical University of Lublin https://orcid.org/0000-0001-7163-6784
  • Karolina Obuchowska Student's Scientific Association at the Chair and Department of Perinatology and Obstetrics, Medical University of Lublin https://orcid.org/0000-0003-4519-8236
  • Aleksandra Obuchowska Student's Scientific Association at the Chair and Department of Perinatology and Obstetrics, Medical University of Lublin https://orcid.org/0000-0003-0464-2695
  • Alicja Ozga Student's Scientific Association at the Chair and Department of Perinatology and Obstetrics, Medical University of Lublin https://orcid.org/0000-0003-1291-905X
  • Arkadiusz Standyło Student's Scientific Association at the Chair and Department of Perinatology and Obstetrics, Medical University of Lublin https://orcid.org/0000-0002-5154-4759
  • Żaneta Kimber-Trojnar Chair and Department of Perinatology and Obstetrics, Medical University of Lublin https://orcid.org/0000-0001-7295-0409
  • Bożena Leszczyńska-Gorzelak Chair and Department of Perinatology and Obstetrics, Medical University of Lublin https://orcid.org/0000-0002-0221-1982

DOI:

https://doi.org/10.12775/JEHS.2020.10.08.052

Keywords

acute coronary syndrome in pregnant women, sudden cardiac arrest in pregnant women, myocardial infarction in pregnant women

Abstract

     Sudden cardiac arrest (SCA) is defined as a significant impairment of the mechanical function of the heart muscle, characterized by the patient's lack of response to stimuli, no perceptible pulse and apnea or agonal breathing, most often caused by acute coronary syndrome (ACS). ACS during pregnancy is a rare phenomenon and its incidence increases with the age of giving birth.The most common cause of ACS in pregnancy are typical changes in the etiology of atherosclerosis or coronary artery thrombosis. Other factors increasing the risk of a heart attack are arterial hypertension, diabetes, obesity and lipid disorders.

    To describe a rare clinical case and demonstrate the importance of maintaining cardiac vigilance in pregnant patients.

    A 32-year-old patient, at 16 weeks of gestation, hospitalized due to an anterior and lateral ST Elevation Myocardial Infarction (STEMI), complicated by SCA due to the mechanism of ventricular fibrillation. The patient was qualified for invasive reperfusion treatment which included left anterior descending (LAD) coronary artery surgery with drug eluting stent (DES) implantation and ballooning of the diagonal first coronary artery. Echocardiography done after treatment revealed apical hypokinesia and left ventricular ejection fraction of 70%. Subsequently the patient was kept under obstetrical and cardiological care. At 37 weeks of gestation, the pregnancy was finished by a successful caesarean section.

      Pregnancy is a state of hypercoagulability and decreased activity of the fibrinolytic system.The clinical management in this case does not differ from the clinical procedure adopted for non-pregnant women. It is important to make a diagnosis quickly and implement a life-saving procedure as soon as possible.

Author Biographies

Żaneta Kimber-Trojnar, Chair and Department of Perinatology and Obstetrics, Medical University of Lublin

dr hab. n. med.

Bożena Leszczyńska-Gorzelak, Chair and Department of Perinatology and Obstetrics, Medical University of Lublin

prof. dr hab. n. med.

References

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Ravichandran J, Woon SY, Quek YS, et al. High-sensitivity cardiac troponin I level in normal and hypertensive pregnancy. The American Journal of Medicine. 2019;132 (3): 362-366.

Elkayam U, Jalanapurkal S, Barakkat M.N, Khatri N. Pregnancy- associated acute myocardial infarction: a review of contemporary experience in 150 cases between 2006-2011.Circulation: Cardiovascular Interventions. 2014; 129 (16): 1695-1702.

Prejbisz A, Dobrowolski P, Kosiński P. Postępowanie w nadciśnieniu tętniczym u kobiet w ciąży. Zapobieganie, diagnostyka, leczenie i odległe rokowanie. Ginekologia i Perinatologia Praktyczna. 2019; 4(2): 43–111.

Bush N, Nelson-Piercy C, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M; UKOSS. Myocardial infarction in pregnancy and postpartum in the UK. Eur J Prev Cardiol 2013;20(1):12–20.

Leonhardt G, Gaul C, Nietsch HH, Buerke M, Schleussner E. Thrombolitic therapy in pregnancy. Journal of thrombosis and thrombolysis. 2015;21 (3): 271-176.

Tawfik MM, Taman ME, Motawea AA, Abdel-Hady E. Thrombolysis for the management of Massie pulmonary embolism in pregnancy. International Journal of Obstetric Anesthesia. 2017; 22 (2): 149-152.

Higgins GL, Borofsky JS, Irish CB, et al. Spontaneous peripartum coronary artery dissection presentation outcome. The Journal of American Board of Family Medicine. 2013; 26(1): 82–89.

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Chang SH, Kuo CF, Chou IJ, et al. Outcomes associated with paroxysmal supraventricular tachycardia during pregnancy. Circulation: Cardiovascular Interventions. 2017; 135(6): 616-618.

Lipman S, Cohen S, Einav S, et al. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the management of cardiac arrest in pregnancy. Anesth Analg. 2014;118:1003–1016.

Lyon DS. (2009). Postpartum Care. Glob. libr. women's med. 2009, doi:10.3843/GLOWM.10143. ISSN 1756-2228.

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Published

2020-08-30

How to Cite

1.
WOJCIK, Justyna, OBUCHOWSKA, Karolina, OBUCHOWSKA, Aleksandra, OZGA, Alicja, STANDYŁO, Arkadiusz, KIMBER-TROJNAR, Żaneta and LESZCZYŃSKA-GORZELAK, Bożena. Sudden cardiac arrest as a result of anterior and lateral myocardial infarction at 16 weeks of gestation - case report. Journal of Education, Health and Sport. Online. 30 August 2020. Vol. 10, no. 8, pp. 428-433. [Accessed 1 July 2025]. DOI 10.12775/JEHS.2020.10.08.052.
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Issue

Vol. 10 No. 8 (2020)

Section

Case Reports

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