Cardiac disease in pregnancy and mitral stenosis

Cardiac disease in pregnancy Microchapters
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Special Scenarios: I. Pre-existing Cardiac Disease: Congenital Heart Disease Repaired Congenital Heart Disease Pulmonary Hypertension Rheumatic Heart Disease Connective Tissue Disorders II. Valvular Heart Disease: Mitral Stenosis Mitral Regurgitation Aortic Insufficiency Aortic Stenosis Mechanical Prosthetic Valves Tissue Prosthetic Valves III. Cardiomyopathy: Dilated Cardiomyopathy Hypertrophic Cardiomyopathy Peripartum Cardiomyopathy IV. Cardiac diseases that may develop During Pregnancy: Arrhythmias Acute Myocardial Infarction Hypertension
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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

• Most hemodynamically important valvular heart disease during pregnancy
• Physiologic changes result in increased heart rate and cardiac output with augmentation of diastolic gradient
• Atrial fibrillation can lead to rapid deterioration
• Volume shifts during delivery can result in pulmonary hypertension or pulmonary edema

Management of Mitral stenosis in Pregnancy

• Restriction of physical activity and salt intake. Avoid supine position
• Beta-blockade to lengthen disatolic filling period
• Diuretics if necessary
• Consideration of invasive monitoring
• Replace blood losses during delivery carefully
• Percutaneous balloon mitral valvuloplasty can be performed during pregnancy if necessary (Class III,IV)

References

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