1/4. Successful thrombolysis of prosthetic mitral valve thrombosis in early pregnancy.Prosthetic valve thrombosis occurring during pregnancy is a life-threatening complication. Surgical treatment requires clot removal or valve replacement under cardiopulmonary bypass, and carries a high mortality. We report successful thrombolytic therapy with streptokinase for prosthetic valve thrombosis in a pregnant, 28-year-old woman. The patient, who had undergone mitral valve replacement (St. Jude Medical prosthesis) two years previously for restenosis after closed mitral valvotomy, was successfully thrombolyzed during the first trimester (6-8 weeks) for prosthetic valve thrombosis, and without any complication. The patient delivered a normal healthy child at nine months' gestation. Although thrombolysis in pregnancy has been reported previously, this is the first case in which it was performed during the first trimester for prosthetic valve thrombosis.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/4. Failure of low molecular-weight heparin in the prevention of prosthetic mitral valve thrombosis during pregnancy: case report and a review of options for anticoagulation.All mechanical heart valves are thrombogenic and may be associated with thromboembolic complications if anticoagulation is inadequate. This risk is increased in pregnancy due to a hypercoagulable state. The ideal anticoagulation regimen in pregnant patients with prosthetic heart valves is uncertain. Oral dicoumarol anticoagulants, subcutaneous low molecular-weight heparin, subcutaneous high-dose heparin and continuous high-dose intravenous heparin each have their own merits and demerits. A case is presented of a pregnant patient who had prosthetic valve thrombosis while receiving low molecular-weight heparin and who required re-do prosthetic mitral valve replacement. An analysis is also included of the options available for anticoagulating this difficult patient group.- - - - - - - - - - ranking = 0.83333333333333keywords = pregnancy (Clic here for more details about this article) |
3/4. coronary thrombosis postpartum in a young woman with Still's disease.A young woman with Still's disease sustained a small myocardial infarction 12 weeks after the delivery of a healthy male infant. This pregnancy was complicated by late onset proteinuric hypertension. coronary angiography nine days after infarction revealed intracoronary thrombus which had resolved by 3 months with antithrombotic therapy. The angiographic appearances at 3 months suggested that a local vasculitis may have been the precipitating cause.- - - - - - - - - - ranking = 0.16666666666667keywords = pregnancy (Clic here for more details about this article) |
4/4. Acute myocardial infarction in pregnancy and puerperium.myocardial infarction during pregnancy and puerperium is very rare. Increased awareness of its possible occurrence is important for diagnosis. A young woman who developed acute myocardial infarction 14 days after labor is described. She had no coronary risk factors; coronary angiography was not done, but ergometric test involving maximal stress done 22 months after confinement did not reveal signs or symptoms of disease. An additional 62 women with myocardial infarction, 51 during pregnancy and 11 in puerperium, reported in the literature were reviewed. The following points were observed: (1) hypertension was present in 25% of cases. (2) Four out of 6 coronary angiograms performed after the infarct were normal. (3) Fifteen patients died (24% mortality). (4) Coronary atherosclerosis was the main finding in 7 out of 9 post-mortem examinations.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |