Comment prendre en charge une femme enceinte atteinte d'une coronaropathie ?

Myocardial infarction is a very rare complication with a 7% mortality rate, during pregnancy, but the incidence increases with the age of the parturient. Coronary artery dissection is a more and more frequent mechanism. Elevated troponin plasma concentration is a specific diagnostic tool in front of atypical symptoms. In pregnant women suffering from coronary artery disease, treatment must be continued except for antagonists of the renin angiotensin receptors. Antiplatelets agents must be interrupted before C-section or epidural. Fibrinolysis for myocardial infarction is contra-indicated by pregnancy, bare stenting is possible to avoid prolonged treatment with antiplatelet agents