Cardiac Diseases in Pregnancy Flashcards

1
Q

Hemodynamic & Cardiovascular changes begin _____ in pregnancy, _______ during the late _____ trimester & remain ________ until delivery.

A

early, peak, 2nd, constant

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2
Q

1st Trimester

A

0 - 13 weeks

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3
Q

2nd Trimester

A

14 - 26 weeks

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4
Q

3rd Trimester

A

27 - 40 weeks

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5
Q

Hemodynamic & Cardiovascular changes affect?

A
  • Cardiac output
  • Blood pressure
  • Systemic vascular resistance
  • Heart rate
  • Blood volume
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6
Q

Define Systemic Vascular Resistance

A

The resistance that must be overcome to push blood through the systemic circulation & create flow.

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7
Q

Change in systemic vascular resistance in pregnancy

(either increases or decreases)

A
  • Drops by approx. 35 - 40% from around 5 wks gestation and nadirs (low point) in the mid-2nd trimester.
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8
Q

Drop in systemic vascular resistance is due to?

A

Systemic vasodilation due to pregnancy

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9
Q

Define Cardiac Output (CO)

A

The volume of blood that is pumped by the heart every minute.

CO = stroke volume (SV) x heart rate (HR)

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10
Q

Cardiac output equation

A

CO = stroke volume (SV) x heart rate (HR)

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11
Q

Change in cardiac output (CO) in pregnancy

(either increases or decreases)

A

It begins to rise in the 2nd trimester & peaks during the 3rd trimester.

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12
Q

Change in heart rate (HR) in pregnancy

(either increases or decreases)

A

HR rises throughout gestation & peaks in late 3rd trimester at average of 16bpm above non-pregnant valves.

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13
Q

Change in blood pressure (BP) in pregnancy

(either increases or decreases)

A

Falls gradually around 12 wks gestation & reaches nadir (low point) at 18 wks gestation
THEN
gradually rises to pre-pregnant levels at term (>37 wks)

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14
Q

Normal pregnancy is characterized by:

A
  • an increase in cardiac output CO
  • reduction in systemic vascular resistance
  • minimal change in mean blood pressure
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15
Q

Change in blood volume in pregnancy

(either increases or decreases)

A

Increases due to increase in plasma volume & red blood cell mass.

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16
Q

There is an increase in total blood volume due to?

A

increase plasma volume & increase red cell mass

17
Q

Change in plasma volume in pregnancy (blood volume)

A
  • Increases by 10 - 15% at 6 - 12 wks gestation
  • Expands rapidly until 30 - 34 wks gestation, then plateaus.
18
Q

Change in red blood cell mass in pregnancy (blood volume)

A
  • begins to increase at 8 - 10 wks gestation
  • steadily rises by 15 - 20% above non-pregnant levels by the end of the pregnancy.
  • increases small relative to plasma volume
19
Q

What is physiological/dilutional anemia in pregnancy?

A

This is when the increase in RBC mass is smaller than the increase in plasma volume, causing a mild decrease in hemoglobin concentration.

20
Q

What are 3 functions or uses of risk assessment tools in pregnancy?

A
  1. Used to evaluate risk of cardiac event during pregnancy in women with heart conditions.
  2. Helps determine frequency of clinical re-evaluation throughout the pregnancy.
  3. Establishes plans for labour, delivery & postpartum.