Acute myocardial infarct plus double mitral lesion in pregnant woman in the third quarter.

Abstract

The coronary disease incidence during pregnancy is around 6,2/100 000. The mainly found risk factors have been: advance maternal age, the presence of classic cardiovascular risk factors, severe anemia and the necessity of post-labor transfusion necessity. The acute myocardial infarct during pregnancy and post-labor has been associated to 5.7-37 % mortality. We presented the case of a pregnant woman aged 27 years with clinical, electrocardiographyc, enzymatic and echocardiographyc diagnosis of acute myocardial infarct with St-segment supra elevation,  of cardioembolic origin due to a mitral valve double lesion. The invasive procedures and thrombolysis do differ, assessing the possible complications. We carried out a medical management with betablockers, thiazide diuretics and aldosterone inhibitors, platelet antiaggregant, anticoagulation with low molecular weight heparins, nitrites when needed, hypolipidemics and omeprazole. Complications were treated timely and pregnancy was interrupted at 34.2 weeks, carrying out a cesarean without complication. After good evolution, the patient was discharged and coronary angiography was programmed a month after the cesarean.