Acute Myocardial Infarction in a Pregnant Woman at Term

MANIFESTATIONS of arteriosclerotic cardiovascular disease are rare in pregnant women. We describe a case of acute myocardial infarction in a woman at 39 weeks' gestation. General guidelines for management of pregnancy associated with this complication are suggested.Report of a CaseA 42-year-old woman (gravida 7, para 6) had a massive anterior-wall myocardial infarction within the 39th week of an otherwise normal pregnancy. Shortly after the onset of her first episode of chest pain, she sustained ventricular fibrillation and was resuscitated successfully. Twenty-four hours later, after severe postarrest congestive heart failure was treated, she was transferred to Beth Israel Hospital, Boston.The patient's first pregnancy had been complicated by preeclampsia, but her others had been uneventful. She had a 20-year history of mild hypertension (treated intermittently with diuretics and propranolol hydrochloride), a five-pack-year smoking history, and a family history of arteriosclerotic cardiovascular disease. Results of her serum lipid profile were