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Emergency Medicine

Training Level

Resident PGY 2


Henry Ford Wyandotte


An acute myocardial infarction (AMI) is a rare complication of pregnancy. The incidence ranges between 3 to 100 per 100,000 live-births. Risk factors include common comorbidities such as smoking, hypertension, hyperlipidemia, diabetes mellitus, sedentary life-style, and obesity. Pregnancy carries additional unique AMI risk factors including advanced maternal age, preeclampsia, thrombophilia, postpartum infection/sepsis and hemorrhages. We describe the unique case of an acute ST-elevation myocardial infarction (STEMI) in a 37 year old woman at 24 weeks gestation with a dichorionic/diamniotic (DCDA) pregnancy. Through serial EKGs and echocardiography, a diagnosis was able to be made despite an atypical clinical presentation of AMI in a pregnant patient. Using a multidisciplinary approach with OB/Gyn and cardiac specialties, the patient had successful medical management and cardiac catheterization which resulted in a positive outcome as the patient recovered well and ultimately delivered healthy twins. Understanding the subtle differences of specific diagnostic and treatment pathways for AMI in pregnancy is essential to improving outcomes in both mother and fetus.

Presentation Date


Three Lives At Stake: A Case of Acute Myocardial Infarction in a Patient with Twin Pregnancy