Acute coronary syndromes in pregnancy: a literature review

Author:

Freeman Amy1,Squire Gareth2,Herrey Anna3,Hogrefe Kai4,Allen Rebecca5

Affiliation:

1. Specialty Registrar, Obstetrics and Gynaecology Homerton University Hospital London E9 6SR UK

2. Specialty Registrar Kettering General Hospital NHS Foundation Trust Kettering Northamptonshire NN16 8UZ UK

3. Consultant Cardiologist Barts Heart Centre West Smithfield, London EC1A 7BE UK

4. Consultant Interventional Cardiologist Kettering General Hospital NHS Foundation Trust Kettering Northamptonshire NN16 8UZ UK

5. Consultant Obstetrician, Subspecialist Maternal and Fetal Medicine Whipps Cross University Hospital Barts Health NHS Trust, London E11 1NR UK

Abstract

Key content Maternal mortality from cardiovascular disease has not improved in almost 20 years; this contrasts to significant sustained improvement in cardiovascular outcomes in the nonpregnant population, particularly regarding acute coronary syndrome (ACS). Many of the women who died in recent MBRRACE‐UK reports presented with cardiac symptoms and signs, but this was not always recognised upon clinical review. The incidence of ACS is increasing alongside advancing maternal age, with an accompanying increased prevalence of typical and pregnancy‐specific cardiac risk factors. Early involvement of senior clinicians and a multidisciplinary approach is crucial for improving maternal outcomes. Counselling women on long term prognosis and implications for future pregnancy is vital. Learning objectives To be aware of the latest data for ACS in pregnancy, including the changing trends in prevalence of this condition and the suggested reasoning behind this. To understand the various presentations of ACS in pregnancy and its differential diagnosis. To understand the possible investigation and management of ACS in pregnancy in a multidisciplinary setting.

Publisher

Wiley

Subject

General Medicine

Reference30 articles.

1. Pregnancy-related acute myocardial infarction: a review of the recent literature

2. Acute Myocardial Infarction Associated With Pregnancy

3. Acute Coronary Syndrome in Pregnancy

4. Acute Myocardial Infarction in Pregnancy

5. KnightM BunchK TuffnellD PatelR ShakespeareJ KotnisR et al.MBRRACE‐UK. Saving lives improving mothers' care: lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017‐19. Oxford: Healthcare Quality Improvement Partnership and National Perinatal Epidemiology Unit University of Oxford; 2021 [https://www.npeu.ox.ac.uk/assets/downloads/mbrrace‐uk/reports/maternal‐report‐2021/MBRRACE‐UK_Maternal_Report_2021_‐_FINAL_‐_WEB_VERSION.pdf].

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