Pregnancy and heart disease congenital heart disease: Difference between revisions
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The most common maternal cardiac disease in Western societies is now congenital heart disease. This includes a wide spectrum of abnormalities, which are delineated in this section. This is largely due in part to the fact that children born with congenital heart defects in Western societies are living to the ages at which they can bear children. This section will not detail those patients that have repaired congenital defects, which are highlighted in the [[Pregnancy and heart disease repaired congenital heart disease|Repaired Congenital Heart Disease]] section. | The most common maternal cardiac disease in Western societies is now congenital heart disease. This includes a wide spectrum of abnormalities, which are delineated in this section. This is largely due in part to the fact that children born with congenital heart defects in Western societies are living to the ages at which they can bear children. This section will not detail those patients that have repaired congenital defects, which are highlighted in the [[Pregnancy and heart disease repaired congenital heart disease|Repaired Congenital Heart Disease]] section. | ||
==[[Atrial septal defect and pregnancy|Atrial Septal | ==[[Atrial septal defect and pregnancy|Atrial Septal Defects]]== | ||
Pregnancy causes an increase in [[cardiac output]] and [[stroke volume]]. This can cause an increased [[left-to-right shunt]]ing of blood. Despite the increased workload on [[heart]], females with isolated asymptomatic [[atrial septal defect]]s tolerate the pregnancy well. Pregnant females with an atrial septal defect may have increased frequencies of some complications for instance [[arrhythmias]], [[thromboembolism]], and [[bleeding]]. Despite this, there are no studies suggesting that pregnancy requires different indications for closure in pregnant females with atrial septal defect compared to a non-pregnant female with [[atrial septal defect]]. The ACC/[[AHA]] guidelines, however, do dictate clear deviations in course of treatment in certain special circumstances. According to ACC/AHA guidelines pregnancy could be harmful in females with [[atrial septal defect]] and severe [[pulmonary hypertension]] ([[Eisenmenger syndrome]]) | Pregnancy causes an increase in [[cardiac output]] and [[stroke volume]]. This can cause an increased [[left-to-right shunt]]ing of blood. Despite the increased workload on [[heart]], females with isolated asymptomatic [[atrial septal defect]]s tolerate the pregnancy well. Pregnant females with an atrial septal defect may have increased frequencies of some complications for instance [[arrhythmias]], [[thromboembolism]], and [[bleeding]]. Despite this, there are no studies suggesting that pregnancy requires different indications for closure in pregnant females with atrial septal defect compared to a non-pregnant female with [[atrial septal defect]]. The ACC/[[AHA]] guidelines, however, do dictate clear deviations in course of treatment in certain special circumstances. According to ACC/AHA guidelines pregnancy could be harmful in females with [[atrial septal defect]] and severe [[pulmonary hypertension]] ([[Eisenmenger syndrome]]) | ||
Revision as of 01:29, 23 September 2011
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Cardiac disease in pregnancy Microchapters |
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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] Priyamvada Singh, M.B.B.S. [3]; Cafer Zorkun, M.D., Ph.D. [4] Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]
Overview
The most common maternal cardiac disease in Western societies is now congenital heart disease. This includes a wide spectrum of abnormalities, which are delineated in this section. This is largely due in part to the fact that children born with congenital heart defects in Western societies are living to the ages at which they can bear children. This section will not detail those patients that have repaired congenital defects, which are highlighted in the Repaired Congenital Heart Disease section.
Atrial Septal Defects
Pregnancy causes an increase in cardiac output and stroke volume. This can cause an increased left-to-right shunting of blood. Despite the increased workload on heart, females with isolated asymptomatic atrial septal defects tolerate the pregnancy well. Pregnant females with an atrial septal defect may have increased frequencies of some complications for instance arrhythmias, thromboembolism, and bleeding. Despite this, there are no studies suggesting that pregnancy requires different indications for closure in pregnant females with atrial septal defect compared to a non-pregnant female with atrial septal defect. The ACC/AHA guidelines, however, do dictate clear deviations in course of treatment in certain special circumstances. According to ACC/AHA guidelines pregnancy could be harmful in females with atrial septal defect and severe pulmonary hypertension (Eisenmenger syndrome)
Ventricular Septal Defects
Congential VSDs are collectively the most common congenital heart defect. The incidence of VSD in adulthood has decreased over past decades due to successful surgical closure of large defects.[1]
Pregnancy in patients with VSD and severe PAH (Eisenmenger syndrome) is not recommended owing to excessive maternal and fetal mortality and should be strongly discouraged. See ACC/AHA guidelines for details.
References
- ↑ Allwork SP, Anderson RH. Developmental anatomy of the membranous part of the ventricular septum in the human heart. Br Heart J 1979; 41:275-280