Obstetric anesthesia considerations in pregnancy-associated myocardial infarction: a focused review

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia Pub Date : 2024-07-17 DOI:10.1016/j.ijoa.2024.104233

E.E. Sharpe , C.H. Rose , M.S. Tweet

引用次数: 0

Abstract

Pregnancy-associated myocardial infarction (PAMI) is a rare but serious complication that can occur either during pregnancy or postpartum. The etiologies of PAMI are atherosclerosis, spontaneous coronary artery dissection, coronary thrombosis, coronary embolism, and coronary vasospasm. Therapy of acute PAMI depends largely on the ECG presentation, hemodynamic stability, and suspected etiology of myocardial infarction. Anesthetic management during delivery in patients with PAMI should consist of early and carefully titrated neuraxial analgesia and anesthesia, maintenance of normal sinus rhythm, preservation of afterload, and monitoring for and avoiding myocardial ischemia. To improve the care of women with PAMI, a multidisciplinary team of cardiologists, maternal fetal medicine specialists, obstetric providers, neonatologists, and anesthesiologists must work collectively to manage these complex patients.

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"妊娠合并心肌梗死的产科麻醉注意事项：重点回顾"

妊娠相关性心肌梗死（PAMI）是一种罕见但严重的并发症，可发生在妊娠期或产后。PAMI 的病因包括动脉粥样硬化、自发性冠状动脉夹层、冠状动脉血栓形成、冠状动脉栓塞和冠状动脉血管痉挛。急性 PAMI 的治疗主要取决于心电图表现、血液动力学稳定性和心肌梗死的可疑病因。PAMI 患者分娩时的麻醉管理应包括早期和仔细滴定的神经镇痛和麻醉、维持正常窦性心律、保护后负荷以及监测和避免心肌缺血。为了改善对 PAMI 患者的护理，由心脏病专家、母体胎儿医学专家、产科医生、新生儿专家和麻醉专家组成的多学科团队必须通力合作，共同管理这些复杂的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of obstetric anesthesia 医学-妇产科学

CiteScore

4.70

自引率

7.10%

发文量

285

审稿时长

58 days

期刊介绍： The International Journal of Obstetric Anesthesia is the only journal publishing original articles devoted exclusively to obstetric anesthesia and bringing together all three of its principal components; anesthesia care for operative delivery and the perioperative period, pain relief in labour and care of the critically ill obstetric patient. • Original research (both clinical and laboratory), short reports and case reports will be considered. • The journal also publishes invited review articles and debates on topical and controversial subjects in the area of obstetric anesthesia. • Articles on related topics such as perinatal physiology and pharmacology and all subjects of importance to obstetric anaesthetists/anesthesiologists are also welcome. The journal is peer-reviewed by international experts. Scholarship is stressed to include the focus on discovery, application of knowledge across fields, and informing the medical community. Through the peer-review process, we hope to attest to the quality of scholarships and guide the Journal to extend and transform knowledge in this important and expanding area.