RT Book, Section
A1 Halpern, Dan G.
A1 Sarma, Amy
A1 Economy, Katherine E.
A1 Valente, Anne Marie
A2 Fuster, Valentin
A2 Harrington, Robert A.
A2 Narula, Jagat
A2 Eapen, Zubin J.
SR Print(0)
ID 1191188650
T1 HEART DISEASE IN PREGNANCY
T2 Hurst's The Heart, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071843249
LK accesscardiology.mhmedical.com/content.aspx?aid=1191188650
RD 2024/04/19
AB SummaryThis  chapter  discusses  cardiovascular  disease  in  pregnancy.  Cardiovascular  disease  complicates  >1%  of  pregnancies  and  is  the  cause  of  one-fifth  of  nonobstetric  maternal  deaths.  Women  with  cardiovascular  disease  should  receive  counseling  on  maternal  and  fetal  risks  prior  to  conceiving.  Pregnancy  is  not  advised  in  patients  with  certain  high-risk  conditions  (see  accompanying  Hurst’s  Central  Illustration).  Women  with  other  types  of  cardiovascular  disease  should  undergo  a  complete  work-up  if  considering  pregnancy;  additionally,  anticipated  or  potential  events  should  be  carefully  planned  for  and  medications  should  be  reviewed  for  their  safety  in  pregnancy.  Up  to  10%  of  pregnancies  are  complicated  by  hypertensive  disorders,  but  many  other  types  of  cardiovascular  disease  may  develop  (for  example,  peripartum  cardiomyopathy)  or  present  particular  challenges  (for  example,  existing  valvular  disease,  aortic  dilatation,  or  some  types  of  congenital  heart  disease).  Additionally,  some  previously  undetected  cardiovascular  disease  can  become  symptomatic  in  pregnancy  (for  example,  valvular  heart  disease  or  congenital  heart  disease).  During  pregnancy,  distinguishing  between  normal  pregnancy  symptoms  and  concerning  cardiac  manifestations  is  often  challenging,  but  various  symptoms,  and  any  that  arise  after  20  weeks  and  become  progressively  worse  or  that  significantly  impair  performance  of  daily  activities,  should  prompt  further  evaluation.  Pregnant  women  with  cardiovascular  conditions  should  be  cared  for  by  expert,  multidisciplinary  teams.  Although  obstetric  complications  are  higher  in  women  with  cardiovascular  disease,  most  women  will  be  able  to  undergo  successful  spontaneous  vaginal  delivery  with  careful  monitoring.