Yonsei Med J.  2005 Dec;46(6):866-869.

An Autopsy Case of Postpartum Acute Myocardial Infarction Associated with Postpartum Ergot Alkaloids Administration in Old-Aged Pregnant Women

• Eom M
• Lee JH
• Chung JH
• Lee H

Abstract

Cases of acute myocardial infarction (AMI) that occur during pregnancy or postpartum are rarely reported. Ergot derivatives are known to induce the spasmodic contraction of coronary arteries. Administration of ergot derivatives can cause AMI, even in normal healthy people. In several reported cases, ergot derivatives triggered severe AMI during the postpartum period. Here, we report the case of a forty-year-old woman who was successfully impregnated by artificial fertilization and died after treatment with ergot derivatives. The autopsy revealed AMI with severe coronary atherosclerosis. This is the first case that reports aggravation of pre-existent severe coronary atherosclerosis after postpartum infusion of ergot derivtives.

Keyword

Myocardial infarction; old age; woman; postpartum; ergot alkaloids

MeSH Terms

Pregnancy
*Postpartum Period
Myocardial Infarction/*chemically induced/diagnosis/pathology
Maternal Age
Humans
Female
Ergot Alkaloids/*adverse effects
Coronary Arteriosclerosis/chemically induced/diagnosis/pathology
Adult

Figure

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  Fig. 1 12-lead ECGs before (A) and after (B) the operation. A) A surface ECG shows sinus tachycardia (105 eats/min). Right axis deviation (RAD) and increased R/S ratio in lead V1 suggest right ventricular hypertrophy. B) A surface ECG shows a similar rate of sinus tachycardia and RAD. ST elevations (arrows) are noted in limb leads II, III, aVF. ST depressions (arrow heads) in precordial leads (V1-2) suggest acute infero-posterior myocardial infarction.

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  Fig. 2 Heart weighs about 388 g and shows flabby appearance.

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  Fig. 3 Left anterior descending coronary artery is near-totally obstructed by atherosclerosis with calcification.

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