Obstetric anesthesia considerations in pregnancy-associated

Int J Obstet Anesth · Nov 2024

Review

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

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. ⋯ 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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- E E Sharpe, C H Rose, and M S Tweet.
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 1st Street S.W., Rochester, MN, United States. Electronic address: sharpe.emily@mayo.edu.
- Int J Obstet Anesth. 2024 Nov 1; 60: 104233104233.
AbstractPregnancy-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.Copyright © 2024 Elsevier Ltd. All rights reserved.

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

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