Featured Research

from universities, journals, and other organizations

Pregnancy increases risk of heart attack

Date:
March 26, 2012
Source:
American College of Cardiology
Summary:
Heart attacks during pregnancy tend to be more severe, lead to more complications, and also occur for different reasons than commonly seen in the non-pregnant general population, suggesting that, in some cases, the standard approach to managing this condition may not always be best, according to new research.

Heart attacks during pregnancy tend to be more severe, lead to more complications, and also occur for different reasons than commonly seen in the non-pregnant general population, suggesting that, in some cases, the standard approach to managing this condition may not always be best, according to research presented March 25 at the American College of Cardiology's 61st Annual Scientific Session.

Related Articles


The changes brought about by pregnancy, including the dramatic shift in hormones and increased volume of blood being pumped through the body, can increase a woman's risk of heart attack during pregnancy and in the 12 weeks after delivery. There is limited clinical information about how to optimally treat -- and perhaps, more importantly, how not to treat -- heart attacks during pregnancy and post partum. This study, which is an extension of two previous surveys by the same research group, analyzed 150 new cases of heart attacks associated with pregnancy occurring since 2005 to better understand how heart attacks occur and are being treated in pregnant women.

The analysis found that most pregnant women did not present with traditional cardiovascular risk factors, such as high blood pressure, diabetes or high cholesterol levels, yet they tended to have more serious heart attacks. In fact, the death rate in these women was 7 percent, which is two to three times higher than what is expected in non-pregnant patients of the same age. In addition, heart attacks in most of these women were caused by different mechanisms than those occurring in the non-pregnant general population.

"Despite advances in the management of myocardial infarction, we found that the rate of severe complications including heart failure, cardiogenic shock, and maternal or fetal mortality continues to be high among pregnant women compared to others," said Uri Elkayam, MD, professor of medicine at the University of Southern California in Los Angeles and the study's lead investigator. "Therefore, every effort should be made for early diagnosis and appropriate treatment of pregnancy-associated acute myocardial infarction. We believe this study provides important information that can help guide clinicians, and hopefully improve the care of these patients."

While atherosclerosis -- or a narrowing of the arteries due to fatty build-up -- is the most common cause of heart attacks in the general population, this was only the cause in one-third of pregnant women. More common among pregnant women was coronary dissection, a separation of the layers of the artery wall that blocks normal blood flow. This is very rare in non-pregnant patients and is thought to occur during and immediately after pregnancy because of the weakening of the wall of the coronary arteries. Researchers also found that coronary dissection may actually be worsened by blind use of guideline-recommended standard therapies such as thrombolytic therapy.

"We have very clear guidelines for treating myocardial infarction in the general population. These guidelines, however, may not always apply to women with pregnancy-associated heart attacks, and may actually cause more harm than good," said Dr. Elkayam. "It is, therefore, important to identify the cause of heart attack in pregnant women before deciding what therapies to use."

In particular, he said coronary angiography to identify the mechanism of heart attack and guide therapy is recommended in high-risk patients when urgent treatment is needed. At the same time, however, in several patients coronary dissection was reportedly caused by coronary angiography or angioplasty and led to either death, a need for extensive stenting or coronary bypass surgery. For this reason, Dr. Elkayam advises that stable and low-risk women with pregnancy-associated heart attack be treated conservatively.

Although the likelihood of having a heart attack during pregnancy is very low -- estimated to occur in 1 in 16,000 deliveries -- this risk is still three to four times higher in pregnant women than in non-pregnant women of the same age, according to Dr. Elkayam. As more women postpone having a first baby, the incidence of this condition is expected to grow.

This analysis included 150 cases published in the literature or consulted by the research team since 2005 and builds upon previous analysis of another 228 cases prior to 2005. More positively, maternal mortality has been decreasing steadily since the first survey, dropping from 16 percent prior to 2005 to 7 percent after 2005.

"This study is another step in better understanding the cause of pregnancy-associated heart attacks and their potential management," said Dr. Elkayam. He is hopeful that a national registry will be created to better track heart attacks in pregnant women and establish optimal protocols that lead to better outcomes.


Story Source:

The above story is based on materials provided by American College of Cardiology. Note: Materials may be edited for content and length.


Cite This Page:

American College of Cardiology. "Pregnancy increases risk of heart attack." ScienceDaily. ScienceDaily, 26 March 2012. <www.sciencedaily.com/releases/2012/03/120326113709.htm>.
American College of Cardiology. (2012, March 26). Pregnancy increases risk of heart attack. ScienceDaily. Retrieved November 25, 2014 from www.sciencedaily.com/releases/2012/03/120326113709.htm
American College of Cardiology. "Pregnancy increases risk of heart attack." ScienceDaily. www.sciencedaily.com/releases/2012/03/120326113709.htm (accessed November 25, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, November 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com
Madagascar Working to Contain Plague Outbreak

Madagascar Working to Contain Plague Outbreak

AFP (Nov. 24, 2014) Madagascar said Monday it is trying to contain an outbreak of plague -- similar to the Black Death that swept Medieval Europe -- that has killed 40 people and is spreading to the capital Antananarivo. Duration: 00:42 Video provided by AFP
Powered by NewsLook.com
Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins