Cardiac disease in pregnancy and arrhythmias: Difference between revisions
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==Overview== | ==Overview== | ||
Although underlying reasons remain unclear, if a woman has a prior history of [[arrhythmias]], the risk of recurrent arrhythmias may increase during pregnancy.<ref> Tawam M, Levine J, Mendelson M, Goldberger J, Dyer A, Kadish A. Effect of pregnancy on paroxysmal supraventricular tachycardia. Am J Cardiol 1993; 72: 838-40.</ref> <ref>Brodsky M, Doria R, Allen B, Sato D, Thomas G, Sada M. New-onset ventricular tachycardia during pregnancy. Am Heart J 1992; 123: 933-41.</ref> <ref name="Chow">Chow T, Galvin J, McGovern B. Antiarrhythmic drug therapy in pregnancy and lactation. Am J Cardiol 1998; 82 (4A): 58I - 62I. </ref> Unfortunately drugs that are effective in the management of arrhythmias such as amiodarone can present a hazard to the fetus during pregnancy. | Although underlying reasons remain unclear, if a woman has a prior history of [[arrhythmias]], the risk of recurrent arrhythmias may increase during pregnancy.<ref> Tawam M, Levine J, Mendelson M, Goldberger J, Dyer A, Kadish A. Effect of pregnancy on paroxysmal supraventricular tachycardia. Am J Cardiol 1993; 72: 838-40.</ref> <ref>Brodsky M, Doria R, Allen B, Sato D, Thomas G, Sada M. New-onset ventricular tachycardia during pregnancy. Am Heart J 1992; 123: 933-41.</ref> <ref name="Chow">Chow T, Galvin J, McGovern B. Antiarrhythmic drug therapy in pregnancy and lactation. Am J Cardiol 1998; 82 (4A): 58I - 62I. </ref> Unfortunately drugs that are effective in the management of arrhythmias such as [[amiodarone]] can present a hazard to the fetus during pregnancy. | ||
==Supraventricular Tachycardias During Pregnancy== | |||
*If there is hemodynamic compromise, the patient can be treated with DC [[cardioversion]]. | |||
*A rapid narrow complex rhythm suggestive of [[AV nodal re-entry tachycardia]] ([[AVNRT]]) can be treated emergently with IV [[adenosine]] which has a very short half life. | |||
==Anti-arrhythmic Drugs to Avoid During the Pregnancy== | ==Anti-arrhythmic Drugs to Avoid During the Pregnancy== | ||
Revision as of 14:17, 11 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Although underlying reasons remain unclear, if a woman has a prior history of arrhythmias, the risk of recurrent arrhythmias may increase during pregnancy.[1] [2] [3] Unfortunately drugs that are effective in the management of arrhythmias such as amiodarone can present a hazard to the fetus during pregnancy.
Supraventricular Tachycardias During Pregnancy
- If there is hemodynamic compromise, the patient can be treated with DC cardioversion.
- A rapid narrow complex rhythm suggestive of AV nodal re-entry tachycardia (AVNRT) can be treated emergently with IV adenosine which has a very short half life.
Anti-arrhythmic Drugs to Avoid During the Pregnancy
- Significant fetal abnormalities.
- Neonatal hypothyroidism
- Fetal goiter
- Fetal growth retardation
- Propranolol and atenolol[5] [6]:
- Intrauterine growth restriction
- Hypoglycemia in the newborn
Anti-arrhythmic Drugs to Avoid During Lactation
- Secreted in breast milk
- It becomes concentrated in breast milk. Infants receive much larger doses.
- Neonatal bradycardia
- Neonatal hypoglycemia
Related Chapters
References
- ↑ Tawam M, Levine J, Mendelson M, Goldberger J, Dyer A, Kadish A. Effect of pregnancy on paroxysmal supraventricular tachycardia. Am J Cardiol 1993; 72: 838-40.
- ↑ Brodsky M, Doria R, Allen B, Sato D, Thomas G, Sada M. New-onset ventricular tachycardia during pregnancy. Am Heart J 1992; 123: 933-41.
- ↑ Chow T, Galvin J, McGovern B. Antiarrhythmic drug therapy in pregnancy and lactation. Am J Cardiol 1998; 82 (4A): 58I - 62I.
- ↑ 4.0 4.1 4.2 Onuigbo M, Alikhan M. Over-the-counter sympathomimetics: a risk factor for cardiac arrhythmias in pregnancy. South Med J 1998; 91: 1153-5.
- ↑ Eliahou HE, Silverberg DS, Reisin E, Romem I, Mashiach S, Serr DM. Propranolol for the treatment of hypertension in pregnancy. Br J Obstet Gynaecol 1978;85:431-6.
- ↑ Lydakis C, Lip GY, Beevers M, Beevers DG. Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens 1999; 12:541-7.