Original data on pregnancy and ACS

Abstract

Background: Although acute coronary syndromes (ACS) occur 3–4 times more in pregnant compared to non-pregnant women, pregnancy-related ACS remain rare. The underlying pathophysiological mechanism is more often non-atherosclerotic. Women with a history of ACS who want to become pregnant need special care because several drugs are contra-indicated during pregnancy and pregnancy after ACS is not without risk. Methods and results: Single centre cohort study (2010–2020) of ACS cases before and during pregnancy or early (<1 month) after delivery in a 1.000 bed tertiary care centre. Multidisciplinary management and outcome of five cases are described: two cases of pregnancy after STEMI, a case of NSTEMI at the end of pregnancy and two cases of STEMI early after delivery. Conclusions: Patients with a history of ACS should be carefully evaluated and counseled before pregnancy. Pregnant patients with a history of ACS and patients who develop ACS during pregnancy require an individualized multidisciplinary approach.

Keywords

• Pregnancy
• Acute coronary syndrome
• Spontaneous coronary artery dissection
• Coronary embolus
• Ischaemic cardiomyopathy
• Cancer treatment