E.S. Smirnova¹, N.I. Maksimov¹, K.A. Herzen¹, R.T. Rizvanova¹, T.A. Martynova²

 ¹Izhevsk State Medical University, Izhevsk

²A.I. Burnasyan Federal Medical Biophysics Center, Moscow

Contact details:

Smirnova E.S. — Assistant Lecturer of the Department of Hospital Therapy with courses of cardiology and functional diagnostics, cardiologist

Address: 281 Kommunarov St., 426034 Izhevsk, Russian Federation, tel.: +7-922-505-61-10, e-mail: smirnovakatya80@mail.ru

ORCID 009-0001-6413-5401

 The article presents a clinical case of acute myocardial infarction (AMI) in a 44-year-old woman with arterial hypertension (AH), aggravated by metabolic syndrome (MS), associated with preeclampsia (PE) at 35 weeks according to anamnesis. Previous PE is regarded as an independent marker of cardiovascular disorders, requiring more active control of risk factors and a multidisciplinary approach.

Material and methods. The article describes a patient with AMI as a long-term result of PE developing after 16 years. It includes the data of medical history, laboratory (troponin I – 31 ng/ml, LDL – 4.0 mmol/l), and instrumental research methods (ECG, Echo-KG, coronary angiography (CAG)). The treatment followed clinical recommendations: angioplasty with stenting of the anterior interventricular branch of the left coronary artery, dual antiplatelet therapy, statins, and beta blockers.

Results. A critical stenosis of the LVEF was revealed, which led to revascularization. During therapy, the condition was stabilized (left ventricular ejection fraction (LVEF) – 53%, regression of symptoms). The analysis of this observation demonstrates the predictive effect of the combined course of metabolic syndrome with PE history on the early development and progression of atherosclerosis at a young age.

Conclusion: PE is an independent marker of high SSR, especially in combination with MS. A multidisciplinary approach is needed for secondary prevention, including aggressive control of hypertension, dyslipidemia, and insulin resistance. Lifelong follow-up of women with a history of PE is recommended in order to reduce the risk of vascular events.

Key words: acute myocardial infarction, metabolic syndrome, preeclampsia, arterial hypertension, pregnancy, secondary prevention, cardiovascular risk

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