Pregnancy Linked To Increased Risk Of Heart Attack

Although acute myocardial infarction (AMI) is rare in women of child-bearing age, pregnancy can increase a woman’s risk of heart attack 3- to 4-fold, according to a study published in the July 15, 2008, issue of the Journal of the American College of Cardiology.

Since women today may delay having children until later in life, and advances in reproductive medicine enable older women to conceive, the occurrence of AMI associated with pregnancy is expected to increase.

“It’s extremely important that physicians who take care of women during pregnancy and after delivery be aware of the occasional occurrence of AMI in pregnancy and not overlook symptoms in these young patients,” said Dr.

Elkayam, who is a professor of Medicine and Obstetrics and Gynecology at USC.

“Although many of the standard principles for diagnosing and treating AMI in non-pregnant patients also apply to pregnant women, two patients need to be treated–the mother and her baby–and the health status of both should play a major role in the selection of diagnostic and therapeutic strategies.”

Some of the standard diagnostic tests and medications (e.g., ACE inhibitors, angiotensin II receptor blockers (ARBs) and warfarin) used to manage AMI can be harmful to the baby, whether in the womb or through breastfeeding; therefore, their use should take into account potential risks and benefits.

There is also limited evidence about the efficacy and safety of other commonly used drugs such as thrombolytic and antiplatelet therapy and devices such as drug-eluting stents, mainly because pregnant patients are routinely excluded from clinical trials.

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