Doctors of USC

Although heart attacks are rare among young women, becoming pregnant does double or triple a woman’s risk, according to a new study led by Uri Elkayam, M.D., professor in the Department of Medicine at the Keck School of Medicine of USC. About 250 pregnant women in the United States each year suffer a heart attack, Elkayam says. However, mortality can be high in these cases, mainly because a diagnosis of heart problems is often missed or delayed. “If somebody has symptoms of what could be a heart attack, the physician needs to consider it in the differential diagnosis in spite of the young age” he says. One of the most common causes of heart attacks among pregnant women in the study was coronary dissection, in which the wall of the coronary arteries is weakened and separates. “This is a rare type of heart attack in non-pregnant patients” Elkayam points out. About 50% of the 103 women reviewed did not have atherosclerosis or blocked arteries, the usual causes of heart attack, he notes. At the same time many of the women did have standard risk factors for heart attack, such as smoking, high cholesterol, family history of heart attack, high blood pressure, and/or diabetes. However, “early diagnosis and appropriate treatment can result in an improvement in outcome,” Elkayam says. “Ten years ago, the mortality rate was 20 percent, now, it’s between 5 and 10 percent. So, we are making progress, but the mortality is still significantly higher then expected in non-pregnant patients of the same age.”