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Reproductive > Cardiomyopathy in Pregancy: Apostolakis-Kyrus > Flashcards

Cardiomyopathy in Pregancy: Apostolakis-Kyrus Flashcards

1
Q

What is GPTPAL?

A

G: Gravida: how many pregnancies
P: How many babies

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2
Q

TPAL?

A

T: Term
P: Preterm
A: Abortion
L: Living

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3
Q

What is a normal ejection fraction?

A

60-70%

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4
Q

What is a hysterotomy?

A

CSection for mother, needed for her survival

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5
Q

What is definition of peripartum cardiomyopathy?

A

Development of cardiac failure in the last month of pregnancy, or within 5 months of delivery

Absence of previous HF, no identifiable cause.

Left ventricular systolic dysfunction demonstrated by classic echo criteria: depressed shortening fraction or ejection franction

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6
Q

What is CM of pregnancy, in terms of diagnosis?

A

Diagnosis of exclusion

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7
Q

What are viral causes of peripartum cardiomyopathy?

A

ParvoB19
Herpes virus 6
Epstein Barr
CMV

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8
Q

What are risks for PPCM?

A 
Chronic HTN
PreEclampsia
Obesity
Smoking
Hx of PP CM
AMA
Extremes of age
AA
multiple gestation: more work
HIV
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9
Q

What is the main risk factor for PP CM ?

A

Chronic HTN

Pre Eclampsia

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10
Q

What are S/Sx of PP CHF?

A 
Dypsnea
Orthopnea
Cough
Palpitations
Chest Pain
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11
Q

What do you see on CXR of PPCM?

A

Enlarged heart

Perihilar opacification

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12
Q

What is EF definition of PPCM?

A

TEST: Less than 45%
NOT TEST: Or fraction shortening less than 30%
Or both

Right ventricular end diastolic dimension greater than 2.7cm (WIDENING!)

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13
Q

What is broad Tx of PPCM?

A

Diuretics: reduce preload
Hydralazine: reduce after load
Digoxin: inotorpic, more efficient
Heparin: prophylactic for stroke

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14
Q

What is the immediate mortality of PPCM?

A

2%

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15
Q

What is important to counsel in terms of pregnancy after birth?

A

Do not get pregnant for the next year!

75% of peole need more than a year to get back up to an EF of >50%

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16
Q

Which is better, idiopathic myopathy or pregnancy myopathy?

A

Pregancy! most people recover within a year or two

17
Q

What is 10 year survival of PP CM? Idopathic? HIV?

A

PP: >90%
Idio: ~60%
HIV: ~25%

We have to diagnose correctly!

18
Q

What is the time breaking point for PP CM long term risk in terms of morbidity and mortality?

A

Recover within 6 months: great

Not recovered 6 months: higher

19
Q

What percent of women will have CM in the next pregnancy?

A

About 1/5

20
Q

TEST: Definition of PPCM?

A
  1. development within last onto or 5 months after birth
  2. absence of another cause
  3. absence of disease present before this one
  4. echo confirms EF/depressed shorteining fraction

Reproductive (31 decks)

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