A CASE OF MYOCARDIAL-INFARCTION COMPLICATING PREGNANCY - A ROLE FOR PROSTACYCLIN SYNTHESIS STIMULATING PLASMA FACTOR AND LIPOPROTEIN (A)

Coronary heart disease and myocardial infarction (MI) is rarely seen i n women below the age of 40 years and even more rarely during pregnanc y. The first case of MI during pregnancy was described by Katz in 1922 (1). Current literature reviewed by Samara et al. 1989 (2) listed onl y 62 cases of proven MI during pregnancy or in the puerperium, the mat ernal mortality rate being as high as 24%. In this paper we are going to report on a 26-year old pregnant woman suffering from MI, probably as a result of a haemostatic imbalance caused by a lack of prostacycli n synthesis stimulating plasma factor (PF) and elevated lipoprotein (a ) (Lp (a)). The potentially deleterious thromboembolic complications i n patients with PF - deficiency, especially in combination with elevat ed Lp (a), should be carefully considered.