期刊
CANADIAN JOURNAL OF CARDIOLOGY
卷 37, 期 12, 页码 2026-2034出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cjca.2021.09.009
关键词
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资金
- Swiss Na-tional Science Foundation [P400PM_191037/1]
- Swiss Heart Foundation [FF20079]
- Prof Dr Max Cloetta Foundation
- Margarete und Walter Lichtenstein-Stiftung [3MS1038]
- University of Basel
- University Hospital Basel
- Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada
- National Institutes of Health
- University of British Columbia Division of Cardiology
- AstraZe-neca
- Abbott Vascular
- St Jude Medical
- Boston Scientific
- Servier
- Swiss National Science Foundation (SNF) [P400PM_191037] Funding Source: Swiss National Science Foundation (SNF)
Coronary events in pregnancy are rare but are becoming more common due to factors such as advancing maternal age and increased traditional cardiac risk factors. Early involvement of a multidisciplinary team is essential for optimizing outcomes for both maternal and fetal health.
Coronary events in pregnancy are a rare but growing cause of maternal morbidity and mortality. Pregnancy presents unique challenges across a broad spectrum of disciplines and requires a multidisciplinary approach to optimise maternal and fetal outcomes. The early involvement of the cardio-obstetrics team in prepregnancy counselling, the antenatal period, delivery, and postpartum is vital to ensuring better outcomes for patients at high risk of coronary pathology. The overall risk for coronary events complicating pregnancy is increasing owing to a number of factors, including advancing maternal age and increases in traditional cardiac risk factors contributing to higher rates of maternal morbidity and mortality. The majority of pregnant women experiencing a coronary event do not have previous coronary disease, and the pathologic mechanisms involved are predominantly non atherosclerotic. Diagnosis and management should follow standard guideline-based practices for acute coronary syndrome (ACS), including the use of diagnostic coronary angiography to guide percutaneous intervention when needed. Management of ACS should not be delayed to facilitate delivery, which can proceed following stent implantation and dual antiplatelet therapy. The timing and mode of delivery should be based on assessment of maternal and fetal status, but vaginal delivery is preferred when possible. This review aims to provide an overview of the major etiologies, risk factors, diagnoses, and management strategies for patients at risk of or presenting with coronary events in pregnancy.
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