Background: Ischemic heart disease (IHD) remains the leading cause of mortality globally, contributing significantly to rising healthcare costs. This study aims to analyze trends in IHD-related mortality from 1999 to 2020 using data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Methods: Mortality data from 1999 to 2020 were extracted from the CDC WONDER database, with IHD identified as the primary cause of death (International Classification of Diseases, 10th Revision Codes: I20–I25). Age-adjusted mortality rates (AAMRs) were calculated and analyzed. Trends were assessed using Joinpoint Regression Analysis to determine the annual percentage change (APC). Additionally, predictive modeling was performed using an autoregressive integrated moving average model implemented in Python and Generative Pre-trained Transformer 4. Results: The study observed a decline in AAMR over the 22-year period, totaling 9 105 056 deaths. The APC revealed a significant decline in mortality rates until 2011 [APC: −4.99, P < 0.05, 95% confidence interval (CI): −5.3 to −4.7], followed by a slower decline through 2020 (APC: −2.35, P < 0.05, 95% CI: −2.8 to −1.6). Both males (AAMR: 161.4, 95% CI: 161.3–161.6) and females (AAMR: 93.1, 95% CI: 93.0–93.2) experienced a continuous decline in APC until 2018, after which trends began to reverse. African Americans had the highest AAMR (144.1, 95% CI: 143.8–144.3), followed by Whites (125.3, 95% CI: 125.3–125.4), American Indians (106.1, 95% CI: 105.0–107.2), Hispanics (92.9, 95% CI: 92.7–93.2), and Asians (67.1, 95% CI: 66.8–67.4). Geographically, the Mid-Atlantic region exhibited the highest AAMR, followed by the East South-Central region. Among states, Oklahoma had the highest AAMR, followed by New York. Non-metropolitan areas had the highest mortality rates, whereas large-fringe metropolitan areas exhibited the lowest. Predictive analysis suggests a potential plateau or slight increase in mortality rates by 2035 (AAMR: 104.5, 95% CI: 50.05–159.64). Conclusions: The observed slowing in the decline of IHD mortality rates and the potential for future increases underscore the need for sustained public health interventions and vigilant surveillance to mitigate the burden of IHD.

Hypertrophic cardiomyopathy is a genetic disease that frequently presents at a young age. Pregnancy represents a state of high physiological stress to the cardiovascular system. Thus, pregnant women with hypertrophic cardiomyopathy face the potential for higher morbidity and, therefore, their management may become a significant challenge when complications develop. Physiologic changes that occur during pregnancy, that is, decreased vascular resistance, increased blood volume, and increased heart rate can lead to worsening heart failure in women with hypertrophic cardiomyopathy. In addition, pregnant women with hypertrophic cardiomyopathy are at higher risk for arrhythmias. The hemodynamic effects of atrial fibrillation and ventricular tachycardia are significant and can be dangerous for the mother and the fetus. In addition, they can lead to heart failure exacerbation. Atrial fibrillation is of particular interest in this population subgroup. Pregnancy is a hypercoagulable state and atrial fibrillation is an arrhythmia associated with significant thromboembolic complications. Patients with hypertrophic cardiomyopathy that develop atrial fibrillation are especially at a higher risk of thrombosis. Anticoagulation is recommended regardless of CHA2DS2-VASc score. Anticoagulation during pregnancy is challenging not only because of the teratogenic effects of some drugs and the lack of evidence for some others, but also the differences in the plasma concentration of many anticoagulants. Overall, the potential for high morbidity in pregnant women with hypertrophic cardiomyopathy is not negligible. Major cardiac events such as arrhythmias and heart failure are common. However, early recognition and treatment of these complications can lead to full-term pregnancy and successful delivery.