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Pregnancy coronary artery spasm

Varalaxmi Bhavani Nannaka, Dmitry Lvovsky
Angina pectoris in pregnancy is unusual and Prinzmetal's angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves' disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70-80 000 IU/L...
2016: Endocrinology, Diabetes & Metabolism Case Reports
Pedro A Villablanca, David F Briceno, Anand D Jagannath, Martin Cohen, Robert Pyo
Coronary vasospasm is uncommon during pregnancy and the postpartum period. We present a very rare case of an acute coronary vasospasm in a 36-year-old woman who was two weeks postpartum. The coronary arteriograms showed a coronary vasospasm in the distal left anterior descending and circumflex coronary arteries. Electrocardiogram (ECG) presentation was atypical, with T-wave inversions in leads I, aVL, and V2 to V6. To our knowledge, this is the first case with a well-documented coronary artery vasospasm in a postpartum woman without the classic ST elevation on ECG...
March 2016: Acute Cardiac Care
Ahmet Gündeş, Ahmet Çelik, İsmail Türkay Özcan, Ahmet Çamsarı
Variant angina, which is also referred to as prinzmetal or coronary vasospastic angina, is a clinical entity characterized by episodes of angina pectoris, usually at rest and often between midnight and early morning, in association with ST-segment elevation on the electrocardiogram. Angina is usually caused by focal spasm of a major coronary artery resulting in a high-grade obstruction, and myocardial infarction may develop in some cases. We report a prinzmetal angina which caused ventricular fibrillation and cardiac arrest in an 18-week pregnant woman...
March 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Philip D Houck, William J Strimel, D Scott Gantt, Walter J Linz
Peripartum myocardial infarction is a rare event that is associated with high mortality rates. The differential diagnosis includes coronary artery dissection, coronary artery thrombosis, vascular spasm, and stenosis. Our evaluation of 2 cases over a 5-year time period has led to a hypothesis that peripartum myocardial infarction is an immune-mediated event secondary to coronary endothelial sensitization by fetal antigen. In our patients, we supplemented standard medical therapy with immunotherapy consisting of corticosteroids, plasmapheresis, and intravenous immunoglobulin...
2012: Texas Heart Institute Journal
Shams Y-Hassan, Tomas Jernberg
Bromocriptine-induced coronary spasm (BICS) causing myocardial infarction has been reported. Association between BICS and Takotsubo syndrome (TS) has not been described. We report on a 37-year-old woman presenting with a clinical picture of acute coronary syndrome 1 day after initiation of treatment with bromocriptine for ablactation 3 weeks after a full-term spontaneous vaginal delivery. Coronary angiography showed diffuse narrowing of a large diagonal branch. Left ventriculography showed widespread hypokinesia extending beyond the diagonal branch supply region...
2011: Cardiology
Angela Kealey
Ischemic heart disease is uncommon during pregnancy, occurring in approximately one in 10,000 live births. With the increasing age and fertility of mothers, the incidence of coronary artery disease in pregnancy is likely to increase. Atherosclerosis appears to be the most common cause of acute myocardial infarction, although coronary spasm, coronary dissection and thrombus have been reported, among others. The diagnosis of ischemic heart disease in the pregnant population can be challenging and not without risk to the fetus...
June 2010: Canadian Journal of Cardiology
J Bessereau, O Desvignes, B Huon, J-Y Roudaut, L Picault, J-J Blanc
A non-smoker 24-year-old woman presented to emergency department of Carhaix (France) for evaluation of acute chest pain. She is pregnant since six weeks and has no risk factors for coronary artery disease; her initial electrocardiogram was compatible with an acute posterior myocardial infarction (AMI). After thrombolysis by tenecteplase and treatment with both aspirin and heparin, she underwent coronary and left ventricular angiography that were normal, methergine test involved no coronary spasm. The mechanism of this AMI was not very clear...
November 2007: Archives des Maladies du Coeur et des Vaisseaux
Kozo Uehara, Hiroyuki Fujinaga, Toru Nakayama, Michiko Yukinaka, Yuji Ozaki, Kazumasa Chikamori, Masahiro Nomura, Yutaka Nakaya, Susumu Ito
A 35-year-old postpartum woman was transferred to our emergency room because of severe precordial pain on the 49th day after delivery. Her ECG up on admission showed ST elevations in leads II, III, and aVF, and an emergency coronary angiography (CAG) demonstrated thrombosis in segment #1 and obstruction in segment #2 of the right coronary artery. Although percutaneous transluminal coronary angioplasty (PTCA) was performed immediately to dilate the stenotic and obstructive regions with balloons, it was not possible to achieve sufficient coronary blood flow TIMI grade 3 coronary blood flow was restored, however, through intracoronary thrombolysis...
2003: Journal of Medicine
Lars B Riisgaard Rasmussen, Birthe Søgaard Andersen, Knud Nørregaard Hansen
Acute myocardial infarction in pregnancy is a rare condition. Two cases of suspected acute myocardial infarction during pregnancy are presented. Acute myocardial infarction in pregnancy is most often caused by atherosclerosis. Other possible aetiologies are dissection, embolism and arterial spasm. Acute coronary angiography is recommended as an early diagnostic procedure that does not present any risk to the embryo. Treatment with aspirin and heparin is safe, but there have been only a few case studies of the use of the newer antithrombotic drugs, chlopidogrel and GPIIb-IIIa inhibitors, in pregnant women...
January 8, 2007: Ugeskrift for Laeger
S W Leung, P S Ng, W Y Wong, T H Cheung
OBJECTIVE: Syntometrine is an effective uterotonic agent used in preventing primary postpartum haemorrhage but has adverse effects including nausea, vomiting, hypertension and coronary artery spasm. Carbetocin is a newly developed long-acting oxytocin analogue that might be used as an uterotonic agent. We compare the efficacy and safety of intramuscular (IM) carbetocin with IM syntometrine in preventing primary postpartum haemorrhage. DESIGN: Prospective, double-blinded, randomised controlled trial...
December 2006: BJOG: An International Journal of Obstetrics and Gynaecology
Danuta Gdyra, Katarzyna Sadkowska, Marek Kuch, Włodzimierz Sawicki, Witold Pietkiewicz, Jerzy Stelmachów, Mirosław Dłuzniewski
Acute myocardial infarction (AMI) during pregnancy and puerperium is very rare. With a growing number of older women giving birth, AMI may become more common complication of pregnancy. We present a 42-year-old multipara with coagulation disorders in pregnancy who suffered from AMI in the peripartum period, documented by ECG, cardiac markers and echocardiography, with normal coronary arteries on angiogram. In conclusion, AMI in pregnancy may be different entity than AMI complicating coronary artery disease. It seems that the main causes of AMI in this population may not be atherosclerotic plaques, but reversible factors, i...
November 2005: Kardiologia Polska
Krzysztof M Kuczkowski
No abstract text is available yet for this article.
February 2006: Archives of Gynecology and Obstetrics
Richard F Edlich, Heidi-Marie A Farinholt, Kathryne L Winters, L D Britt, William B Long
Lightning is the second most common cause of weather-related death in the United States. Lightning is a natural atmospheric discharge that occurs between regions of net positive and net negative electric charges. There are several types of lightning, including streak lightning, sheet lightning, ribbon lightning, bead lightning, and ball lightning. Lightning causes injury through five basic mechanisms: direct strike, flash discharge (splash), contact, ground current (step voltage), and blunt trauma. While persons struck by lightning show evidence of multisystem derangement, the most dramatic effects involve the cardiovascular and central nervous systems...
2005: Journal of Long-term Effects of Medical Implants
Toshihisa Ichiba, Hiroyuki Nishie, Waso Fujinaka, Keiichi Tada
We experienced acute myocardial infarction due to coronary artery spasm after caesarean section. A 41-year-old multigravida woman with no previous cardiac history or coronary risk factor developed acute myocardial infarction after caesarean section, and was successfully resuscitated with emergency percutaneous transluminal coronary angioplasty. Acute myocardial infarction during pregnancy and postpartum period is a rare event, but could be associated with high mortality if it occurs. It is necessary to consider the possibility of acute myocardial infarction and provide early diagnosis and treatment by multidisciplinary team when a pregnant woman complains of retrosternal chest pain...
January 2005: Masui. the Japanese Journal of Anesthesiology
Yuji Hayashi, Toshio Ibe, Hiroaki Kawato, Noritaka Futamura, Sukenari Koyabu, Uichi Ikeda, Kazuyuki Shimada
We report a primigravida woman with acute myocardial infarction caused by coronary artery spasm induced by intravenous administration of methyl ergometrine maleate just after delivery. Despite the frequent usage of ergot derivatives to promote uterine contractions, cardiac complications related to this drug are rare. Myocardial infarction may be overlooked in young women in the early postpartum period. Careful monitoring and prompt evaluation should be performed when this drug is administered for obstetrical purposes...
October 2003: Internal Medicine
Mohammad D Khan, Shakeel A Qureshi, Eric Rosenthal, Gurleen K Sharland
A large fistula from the right coronary artery to the right atrium was diagnosed in a fetus at 22 weeks of gestation. Following delivery, the baby developed cardiac failure. The fistula was occluded at 3 weeks of age by transcatheter implantation of an Amplatzer duct occluder. Large coronary fistulas can be closed safely with a device even at this early age. Vigilance for ischemic events is required following implantation because of the rare possibility of thrombus extension proximally into the native coronary artery or spasm of the coronary artery...
October 2003: Catheterization and Cardiovascular Interventions
Dirk Härtel, Eckhard Sorges, Jörg Carlsson, Volker Römer, Ulrich Tebbe
Acute myocardial infarction is a very rare event during pregnancy and bears the problem of misdiagnosis. However, about 150 cases have been published worldwide with a preponderance of anterior wall infarcts. With more women delaying childbearing until an older age and increasing prevalence of smoking in young women, it can be expected that all forms of coronary artery disease--including acute myocardial infarction--will be seen more often in the future. Among the causes of coronary artery occlusion in pregnancy are (1) rupture of very small coronary artery plaques triggered by different events, e...
May 2003: Herz
Vithaya Chaithiraphan, Ramesh M Gowda, Ijaz A Khan, Carl D Reimers
Acute myocardial infarction in pregnancy and puerperium is an uncommon event with substantial morbidity and mortality rates. Atherosclerosis may be the cause, but often the coronary arteries are healthy at angiography. In such cases, the suggested mechanism is a decreased coronary perfusion related to coronary spasm or in situ thrombosis. Most pregnant women who died after myocardial infarction did so at the time of initial infarction, and maternal mortality was greatest if the infarction was late in pregnancy...
January 2003: American Journal of Therapeutics
F Bayoumeu, M Aallali, A Koebele, G Steschenko, M C Laxenaire
A case of chest pain in a 31-year-old woman after vaginal delivery with epidural analgesia during sulprostone administration is described. Chest pain occurred shortly after sulprostone was started and disappeared when sulprostone was stopped. Ischaemia related data were negative. Angiographically coronary arteries were normal. Coronary artery spasm aetiology was retained. Sulprostone pharmacology is summarized. Coronary artery effects are compared with literature reports. Recommendations before sulprostone use are underlined...
October 2002: Annales Françaises D'anesthèsie et de Rèanimation
M Mauser, P Billmann, D Fleischmann
A myocardial infarction is a rare complication of a pheochromocytoma. A pheochromo-cytoma crisis may occur spontaneously, during pregnancy, or may be induced by a local trauma of the tumor or by drugs. We present a case report of a 41-year-old woman without anamnestic episodes of hypertension or angina pectoris. During angiography of the mesenteric arteries for further diagnostics of a sonographically suspected liver tumor, she developed an acute pulmonary edema and a cardiogenic shock with the electro- and echocardiographic findings of a large anterolateral-apical-diaphragmal myocardial infarction...
April 2001: Zeitschrift Für Kardiologie
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