oxytocin and Thrombophilia

We report a case of a middle-aged woman presenting with ST elevation myocardial infarction in early puerperium after Caesarean intervention secondary to left main coronary artery thrombosis, likely to be associated with thrombophilic state and concomitant use of oxytocin.

Topics: Adult; Angioplasty, Balloon, Coronary; Blood Coagulation Tests; Cesarean Section; Coronary Angiography; Coronary Thrombosis; DNA Mutational Analysis; Electrocardiography; Factor V; Female; Humans; Intra-Aortic Balloon Pumping; Mutation; Myocardial Infarction; Oxytocics; Oxytocin; Postpartum Period; Pregnancy; Thrombophilia; Treatment Outcome

Maternal heart disease during pregnancy is the main cause of obstetric morbidity and mortality. We report the case of a 40-year-old woman with a history of myocardial infarction and percutaneous transluminal coronary angioplasty. The patient suffered a second heart attack and received pharmacologic treatment. After admission, she was seen to be 29 weeks pregnant. Delivery was by cesarean section under progressive epidural block without complications. We review the medical, obstetric, and anesthetic implications of myocardial infarction during pregnancy. The management of such patients should be multidisciplinary and decisions about delivery should be taken based on obstetric considerations.

Topics: Adult; Angioplasty, Balloon, Coronary; Cardiovascular Agents; Cesarean Section; Combined Modality Therapy; Contraindications; Coronary Angiography; Diagnosis, Differential; Elective Surgical Procedures; Ergotamine; Female; Humans; Myocardial Infarction; Myocardial Ischemia; Obesity, Morbid; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy, High-Risk; Recurrence; Stents; Thrombophilia