[Myocardial infarction in the peripartum period in a 42-year-old multipara with normal coronary arteries].

Acute myocardial infarction (AMI) during pregnancy and puerperium is very rare. With a growing number of older women giving birth, AMI may become more common complication of pregnancy. We present a 42-year-old multipara with coagulation disorders in pregnancy who suffered from AMI in the peripartum period, documented by ECG, cardiac markers and echocardiography, with normal coronary arteries on angiogram. In conclusion, AMI in pregnancy may be different entity than AMI complicating coronary artery disease. It seems that the main causes of AMI in this population may not be atherosclerotic plaques, but reversible factors, i.e. vessel spasm or coagulation disorders. This may explain why in our patient symptoms of AMI were dramatic in spite of a small area of necrosis and normal coronary angiograms.