Acute Inferior Wall Myocardial Infarction and Percutaneous Coronary Intervention of the Right Coronary during Active Labor: A Clinical Report and Review of the Literature

Acute myocardial infarction (AMI) is a rare event in women of childbearing age and has been estimated to occur at a rate of 1 in 10,000 women during pregnancy. First reported on in 1922, subsequent reports appeared in the literature indicating the unique features of this condition which can significantly affect both maternal and fetal outcomes. With the current maternal trend of childbearing at an older age, in addition to the effects of cigarette smoking, stress and cocaine use, the occurrence of AMI during pregnancy, albeit uncommon, can be expected to increase. In this article we describe a unique case of a 42-year-old woman with an acute inferior wall MI who underwent a percutaneous angioplasty and placement of a bare-metal stent during active labor. The patient tolerated the procedure well and underwent a successful cesarean section with delivery of twins. The subsequent discussion examines the clinical aspects of gestational and early postpartum AMI and reviews current strategies for both diagnosis and treatment.