Acute myocardial infarction in pregnancy with subsequent medical and surgical management.

Abstract

Myocardial infarction is a rare event in pregnancy that requires medical stabilization with possible surgical interventions. A 37-year-old woman developed an anterior wall myocardial infarction secondary to severe coronary artery disease during the early third trimester of pregnancy. The patient was managed with multiple modalities to stabilize her condition and prolong the gestation. The salient point in the management included: defibrillation and pharmacologic agents, intra-aortic balloon pump, coronary artery bypass graft surgery using a cardiopulmonary bypass pump while maintaining continuous fetal heart rate monitoring, and delivery of the neonate at term. Aggressive management of this patient allowed continuation of pregnancy with good outcome for mother and neonate.