Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4294-4302
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4294
Acute myocardial infarction in twin pregnancy after assisted reproduction: A case report
Ni-Ni Dai, Rong Zhou, Yan-Ling Zhuo, Li Sun, Ming-Yue Xiao, Si-Jing Wu, Hai-Xu Yu, Qiu-Yu Li
Ni-Ni Dai, Qiu-Yu Li, Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
Rong Zhou, Department of Sleep Medicine, Peking University Sixth Hospital, Beijing 100191, China
Yan-Ling Zhuo, Li Sun, Ming-Yue Xiao, Department of Rehabilitation, Beijing United Family Rehabilitation Hospital, Beijing 100016, China
Si-Jing Wu, Department of Cardiology, Beijing Anzhen hospital, Beijing 100029, China
Hai-Xu Yu, Department of Cardiology, Peking University Third Hospital, Beijing 100191, China
Author contributions: Dai NN reviewed the literature and contributed to manuscript drafting and revising; Zhou R and Li QY were the patient’s doctors and contributed to collecting the patient’s medical data and making a revision to the manuscript; Zhuo YL, Sun L, and Xiao MY contributed to the management and follow-up of the patient; Wu SJ and Yu HX contributed to making a revision to the manuscript; Li QY also contributed to conceptualization, methodology, and funding acquisition; all authors issued final approval for the version to be submitted.
Supported by National Natural Science Foundation of China, No. 81900641.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiu-Yu Li, MD, Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. liqiuyu19871011@foxmail.com
Received: January 14, 2021
Peer-review started: January 14, 2021
First decision: March 8, 2021
Revised: March 16, 2021
Accepted: April 20, 2021
Article in press: April 20, 2021
Published online: June 16, 2021
Processing time: 132 Days and 5.1 Hours
Abstract
BACKGROUND

Acute myocardial infarction (AMI) during pregnancy is rare, especially in twin pregnancy, and it can endanger the lives of the mother and children. Except for conventional cardiovascular risk factors, pregnancy and assisted reproduction can increase the risk of AMI during pregnancy. AMI develops secondary to different etiologies, such as coronary spasm and spontaneous coronary artery dissection.

CASE SUMMARY

A 33-year-old woman, with twin pregnancy in the 31st week of gestation, presented to the hospital with intermittent chest tightness for 12 wk, aggravation for 1 wk, and chest pain for 4 h. Combined with the electrocardiogram and hypersensitive troponin results, she was diagnosed with acute ST-elevation myocardial infarction. Although the patient had no related medical history, she presented several risk factors, such as age greater than 30 years, assisted reproduction, and hyperlipidemia. After diagnosis, the patient received antiplatelet and anticoagulant treatment. Cesarean section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary artery. After receiving medication, the patient was in good condition.

CONCLUSION

This case suggests that, with the widespread use of assisted reproductive technology, more attention should be paid to perinatal healthcare, especially when chest pain occurs, to facilitate early diagnosis and intervention of AMI, and the etiology of AMI in pregnancy needs to be differentiated, especially between coronary spasm and spontaneous coronary artery dissection.

Keywords: Acute myocardial infarction; Twin pregnancy; Assisted reproduction; Coronary spasm; Spontaneous coronary artery dissection; Case report

Core Tip: Acute myocardial infarction (AMI) during pregnancy is rare, especially in twin pregnancy. Pregnancy and assisted reproduction can increase the risk of AMI. AMI develops secondary to different etiologies, such as spontaneous coronary artery dissection. Herein, we present a case of AMI in a 33-year-old woman with twin pregnancy in the 31st week of gestation. She presented several risk factors, such as advanced age, assisted reproduction, and hyperlipidemia. The case suggests that more attention should be paid to perinatal healthcare, especially when chest pain occurs, and the etiology of AMI in pregnancy needs to be differentiated.