임신 중 발생한 심근경색 1예
A case of myocardial infarction during pregnancy
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=최근, 식이 및 생활양식의 변화에 의한 고혈압과 관상동맥 질환이 증가하고 있다. 관상동맥 질환은 가임기 젊은 여성에겐 상대적으로 드문 질환이지만, 고령 임신이 증가함에 따라 임신 시 관상동맥 질환도 증가할 것으로 예상된다. 임신 시 심근경색은 태아와 산모에게 위험할 수 있는데 전체적 모성 사망률은 21-35%이며 태아 사망률은 13%이다. 심근경색이 발생한 산모치료에서 유의할 부분은 심근경색 발생 2주 내에 분만할 경우 모성 사망률은 50%에서 달한다는 점이다. 저자들은 만성고혈압으로 약물복용중이던 산모에게서 임신 36주 5일에 급성심근경색이 발생하여 내과적 처치후 경과관찰중 임신 39주 3일에 유도 분만하여 정상 분만한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Recently, the incidence of hypertension (HT) and coronary artery disease is increasing because of the change of diet and life pattern. But, coronary artery disease is relatively uncommon in young women of pregnant age. The trend towards delayed marriage and child-bearing may results in an increasing number of women with coronary heart disease. Myocardial infarction complicates approximately 1 in 20,000 pregnancies. Myocardial infarction in pregnancy carries substantial maternal and fetal risks. Overall maternal mortality rate is 21% to 35% and the fetal mortality rate is 13%. Importantly, the maternal mortality rate approaches 50% when women deliver within 2 weeks of the initial MI event. We experienced a case of pregnancy with acute myocardial infarction (AMI) and chronic HT. The patient had a myocardial attack at gestational age 36+5 weeks and medical treatment was administered. Labor inuction was begun at gestational age 39+3 weeks and the patient delivered by spontaneous vaginal delivery. We report this case with a brief review of the concerned literatures.
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