The treatment of gestational hypertension combined with acute myocardial infarction is challenging. This paper discussed the difficulties in the treatment of acute ST segment elevation myocardial infarction (inferior wall) in a 34-year-old patient with gestational hypertension, as well as the experience and basis of successful treatment of serious cardiovascular diseases endangering elderly pregnant women and fetuses. At the same time, this paper searched the reports of similar cases at home and abroad, in order to explore the management strategies of such rare but high-risk pregnant women with cardiovascular disease.

1.Cauldwell M, Baris L, Roos-Hesselink JW, et al. Ischaemic heart disease and pregnancy[J]. Heart, 2019, 105(3): 189-195. DOI: 10.1136/heartjnl-2018-313454.

2.Campbell KH, Tweet MS. Coronary disease in pregnancy: myocardial infarction and spontaneous coronary artery dissection[J]. Clin Obstet Gynecol, 2020, 63(4): 852-867. DOI: 10.1097/GRF.0000000000000558.

3.Sinkey RG, Battarbee AN, Bello NA, et al. Prevention, diagnosis, and management of hypertensive disorders of pregnancy: a comparison of international guidelines[J]. Curr Hypertens Rep, 2020, 22(9): 66. DOI: 10.1007/s11906-020-01082-w.

4.McBeth BD, Rosenstein DI. Acute aortic dissection with ST segment myocardial infarction following masturbation[J]. J Emerg Med, 2020, 58(4): e193-e196. DOI: 10.1016/j.jemermed.2020.01.007.

5.Kealey A. Coronary artery disease and myocardial infarction in pregnancy: a review of epidemiology, diagnosis, and medical and surgical management[J]. Can J Cardiol, 2010, 26(6): 185-189. DOI: 10.1016/s0828-282x(10)70397-4.

6.Zheng L, Xia B, Yuan Y, et al. Low-molecular-weight heparin in addition to low-dose aspirin for preventing preeclampsia and its complications: a systematic review and Meta-analysis[J]. Front Cardiovasc Med, 2022, 9: 1073148. DOI: 10.3389/fcvm.2022.1073148.

7.Long A, Long B, Koyfman A. Non-traditional risk factors for atherosclerotic disease: a review for emergency physicians[J]. Am J Emerg Med, 2018, 36(3): 494-497. DOI: 10.1016/j.ajem.2017.12.036.

8.Lau E, DeFaria Yeh D. Management of high risk cardiac conditions in pregnancy: anticoagulation, severe stenotic valvular disease and cardiomyopathy[J]. Trends Cardiovasc Med, 2019, 29(3): 155-161. DOI: 10.1016/j.tcm.2018.07.009.

9.Roos-Hesselink J, Baris L, Johnson M, et al. Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC registry of pregnancy and cardiac disease (ROPAC)[J]. Eur Heart J, 2019, 40(47): 3848-3855. DOI: 10.1093/eurheartj/ehz136.  

10.Alameh A, Jabri A, Aleyadeh W, et al. Pregnancy-associated myocardial infarction: a review of current practices and guidelines[J]. Curr Cardiol Rep, 2021, 23(10): 142. DOI: 10.1007/s11886-021-01579-z.

11.Balgobin CA, Zhang X, Lima FV, et al. Risk factors and timing of acute myocardial infarction associated with pregnancy: insights from the national inpatient sample[J]. J Am Heart Assoc, 2020, 9(21): e016623. DOI: 10.1161/JAHA.120.016623.

12.Honigberg MC, Scott NS. Pregnancy-associated myocardial infarction[J]. Curr Treat Options Cardiovasc Med, 2018, 20(7): 58. DOI: 10.1007/s11936-018-0655-6.

13.Edupuganti MM, Ganga V. Acute myocardial infarction in pregnancy: current diagnosis and management approaches[J]. Indian Heart J, 2019, 71(5): 367-374. DOI: 10.1016/j.ihj.2019.12.003.

14.Regitz-Zagrosek V. Myocardial infarction in pregnancy: how frequent, how fatal?[J]. Eur Heart J Qual Care Clin Outcomes, 2017, 3(3): 171-172. DOI: 10.1093/ehjqcco/qcx006.

15.Petri M. Pregnancy and systemic lupus erythematosus[J]. Best Pract Res Clin Obstet Gynaecol, 2020, 64: 24-30. DOI: 10.1016/j.bpobgyn.2019.09.002.

16.Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention[J]. Int J Gynaecol Obstet, 2019, 145(Suppl 1): 1-33. DOI: 10.1002/ijgo.12802.

17.Lameijer H, Kampman MA, Oudijk MA, et al. Ischaemic heart disease during pregnancy or post-partum: systematic review and case series[J]. Neth Heart J, 2015, 23(5): 249-257. DOI: 10.1007/s12471-015-0677-6.

18.O'Kelly AC, Ludmir J, Wood MJ. Acute coronary syndrome in pregnancy and the post-partum period[J]. J Cardiovasc Dev Dis, 2022, 9(7): 198. DOI: 10.3390/jcdd9070198.

19.Oliver-Williams C, Stevens D, Payne RA, et al. Association between hypertensive disorders of pregnancy and later risk of cardiovascular outcomes[J]. BMC Med, 2022, 20(1): 19. DOI: 10.1186/s12916-021-02218-8.

20.Chavez P, Wolfe D, Bortnick AE. Management of ischemic heart disease in pregnancy[J]. Curr Atheroscler Rep, 2021, 23(9): 52. DOI: 10.1007/s11883-021-00944-1.