Myocardial infarction and pregnancy

Abstract

The article presents an analysis of circulatory disorders in the coronary vessels during pregnancy, childbirth, and the postpartum period. In recent years, there has been a tendency towards an increase in the level of maternal mortality associated with cardiovascular diseases. There has been a rise in the incidence of myocardial infarction and acute coronary syndrome both during pregnancy and childbirth. These indicators are associated with physiological changes in the main parameters of hemodynamics and the hemostatic system at different stages of gestation, which often provokes or complicates the development of coronary heart disease. The main pathogenetic mechanisms responsible for the development of cardiac catastrophe, such as atherosclerosis, spontaneous dissection of the coronary arteries, coronary thrombosis, and vasospasm, are considered. Particular attention is paid to the characteristic features of the clinical picture and the importance of modern diagnostic methods in establishing an accurate diagnosis, including determining the level of troponin, pregnancy-associated plasma protein A, transthoracic and transesophageal echocardiography, and coronary angiography. The basic principles of managing pregnancy with coronary heart disease at different stages have been determined, including the choice of delivery method and management in the postpartum period. The issues of pharmacological therapy are considered, taking into account the possible negative impact on the health of the mother and fetus.