MYOCARDIAL-INFARCTION IN PREGNANCY DURING TREATMENT WITH SALBUTAMOL

The authors report the case of a 31 year old woman at 30 weeks' gestat ion who developed a non-Q wave postero-lateral myocardial infarction d uring treatment with salbutamol. There were no complications and deliv ery took place at term normally. Coronary angiography was performed 3 months post-partum and was normal: the Methergin test was negative. My ocardial ischaemia occurring during treatment with a beta-2 mimetic in pregnancy is rare and hardly ever progresses to myocardial infarction . The usual mechanism of ischaemia is an imbalance of myocardial oxyge n demand and supply. Myocardial oxygen consumption is naturally increa sed during pregnancy and Excess intracellular calcium secondary to the beta-1 stimulation occurring with the use of beta-2 mimetic drugs fur ther aggravates matters. This hypothesis raises the question of the va lue of calcium inhibitors in these forms of myocardial ischaemia.