While acute coronary syndromes (ACSs) during pregnancy are relatively uncommon (1.7–6.2 per 100 000 deliveries), pregnancy-associated MI (PAMI) is responsible for more than 5% of maternal cardiac mortality.8–10 Distinct from the general population, the majority of PAMI cases are driven by non-atherosclerotic mechanisms such as SCAD (43%) and coronary thrombosis (17%) and nearly 18% exhibit angiographically normal coronary arteries.8,11 Coronary vasospasm accounts for 2%–5% of PAMI and is likely triggered by elevated renin and angiotensin levels.8,12. This evidence concerns the gene REN and acute coronary syndrome.