Hypertrophic cardiomyopathy management during pregnancy

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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Women with hypertrophic cardiomyopathy should be managed by a skilled cardiovascular specialist and a high-risk obstetrician during pregnancy. Any activity, drug or circumstance that increases left ventricular outflow obstruction, reduced left ventricular filling, or increases left ventricular afterload should be avoided.

Activities That Increase Left Ventricular Outflow Tract Obstruction

The following activities increase left ventricular outflow tract obstruction and should be avoided:

• Nausea and vomiting
• Dehydration
• Hypovolemia (i.e., use diuretics with caution)
• Medications that reduce preload and left ventricular filling such as nitrates

Activities That Increase Afterload

The following activities increase left ventricular afterload should be avoided:

• Intense isometric exercise