Cardiac Disease in Pregnancy

Question 1

Which maternal cardiac issues are safe in pregnancy?

Answer 1

Mitral valve prolapse, uncomplicated VSDs or ASDs

Question 2

What is the management for a woman with pulmonary hypertension in pregnancy?

Answer 2

Contraindicated, termination of pregnancy recommended.

Question 3

Why could aortic stenosis be dangerous in pregnancy?

Answer 3

Can cause inability to increase cardiac output.

Question 4

What is the treatment for aortic stenosis in pregnancy?

Answer 4

Beta-blocker

Question 5

What is contraindicated in aortic stenosis during delivery due to the risk of hypotension?

Answer 5

Epidural anaesthesia

Question 6

Is mitral valve disease dangerous in pregnancy?

Answer 6

Mitral stenosis is, monitor with echo.

Question 7

What is the management of a pregnant women with Marfan syndrome?

Answer 7

1. Root replacement pre-pregnancy

2. C-section if >4.5cm

Question 8

How is AF treated in pregnancy?

Answer 8

Aggressively - digoxin and beta-blockers

Question 9

What should change in the medications management of a pregnant woman with an artificial valve?

Answer 9

Swap warfarin for LMWH due to teratogenicity

Question 10

What is this a description of?

Develops 1 months pre or 5 months postpartum in the absence of a recognisable cause. Rare cause of heart failure.

Answer 10

Peripartum cardiomyopathy

Question 11

How is peripartum cardiomyopathy diagnosed and managed?

Answer 11

1. Echocardiograph

2. Elective delivery, use heart failure medications after.