Cardiac disease in pregnancy overview: Difference between revisions
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==Overview== | ==Overview== | ||
Revision as of 15:49, 18 August 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Anjan K. Chakrabarti, M.D. [2]
Overview
Approximately 1-4% of pregnancies in the United States involve maternal cardiovascular disease. In fact, pregnancy can "unmask" underlying cardiovascular disease, due to hemodynamic changes associated with pregnancy. [1] With a careful pre-pregnancy evaluation, most women with cardiovascular disease can have a pregnancy with proper care.
Epidemiology and Demographics
Increasing numbers of women with congenital heart disease are now reaching childbearing age, making congential heart disease the most common form of heart disease complicating pregnancy in the United States. Rheumatic heart disease is still prevalent in the developing world and in immigrant populations. Overall, maternal death during pregnancy in women with heart disease is rare, but certain conditions are associated with an increased mortality.[2]
Disorders Associated with Cardiovascular Disease in Pregnancy
Maternal cardiovascular disease includes (most commonly) congenital disease, dilated and hypertrophic cardiomyopathies, valvular disease (with as mitral valve prolapse), pulmonary hypertension, and coronary disease. Other cardiovascular problems seen include cardiomyopathies, both dilated and hypertrophic, and valvular disease, such as bicuspid aortic valve and mitral valve prolapse. Less common problems include pulmonary hypertension and, rarely, coronary artery disease. Any of the above require a strategy regarding the frequency of follow-up by the cardiologist and a plan for labor and delivery.[3]
Risk Factors
Siu et al. have developed a risk score for pregnant women with cardiovascular disease, and found that prior cardiac events or arrhythmia, poor functional class or cyanosis, left heart obstruction, and left ventricular systolic dysfunction independently predicted maternal cardiac complications.[4]
Diagnosis
Physical Examination
ECG
Echocardiography
Treatment
References
- ↑ Roos-Hesselink JW, Duvekot JJ, Thorne SA (2009). "Pregnancy in high risk cardiac conditions". Heart. 95 (8): 680–6. doi:10.1136/hrt.2008.148932. PMID 19329725.
- ↑ Siu SC, Colman JM (2001). "Heart disease and pregnancy". Heart. 85 (6): 710–5. PMC 1729784. PMID 11359761.
- ↑ Thorne SA (2004). "Pregnancy in heart disease". Heart. 90 (4): 450–6. PMC 1768170. PMID 15020530.
- ↑ Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC; et al. (2001). "Prospective multicenter study of pregnancy outcomes in women with heart disease". Circulation. 104 (5): 515–21. PMID 11479246.