Key role of multimodal imaging in a rare case of pregnancy-associated myocardial infarction: A diagnostic and therapeutic challenge

With rising maternal age, cardiovascular risk factors, including hypertensive disorders and congenital heart disease, are more pronounced, contributing to the increasing incidence of cardiovascular disease, the leading cause of maternal mortality in Europe [1].Although acute coronary events during pregnancy are often caused by spontaneous coronary artery dissection, myocardial infarction due to coronary thrombosis in young, low-risk women remains rare [2].Preeclampsia, through release of anti-angiogenic factors, is associated with endothelial dysfunction, inflammation, and coagulation activation, creating a prothrombotic milieu that may contribute to coronary artery disease [1,3].In such cases, multimodal imaging is essential for accurate diagnosis and timely, targeted management.A 31-year-old woman was admitted with chest pain and electrocardiographic signs of acute anterolateral ST-elevation myocardial infarction.Symptoms began 90 minutes earlier and represented her first manifestation of coronary artery disease.She had delivered her fourth child eight days prior via urgent cesarean section for preeclampsia at 37 gestational weeks.Apart from active smoking, she had no risk factors.On admission, she was stable (BP 118/80 mm Hg; HR 80/min), in sinus rhythm, Killip I.