Cardiovascular Disorder Flashcards
TRUE OR FALSE
If the CVD problem was severe, the woman
will not be encouraged to get pregnant?
True
The danger of pregnancy in a woman with cardiac
disease occurs due to
increase in circulatory volume (30-50%)
______still encouraged for patients with CVD disorder
as CS has greater blood loss
NSD
Decreased in Cardiac Output =
Altered Maternal–Fetal Circulation
SIGNS AND SYMPTOMS
● Respi Distress - DOB, SOB
● Orthopnea
● Tachycardia/Palpitations
● Murmurs
○ Systolic, Midsystolic, Machinery Like - PDA
● Edema
● Chest Pain
COMPLICATIONS
● Premature Birth
● IUGR
● Respiratory Distress
○ Nursing Action: Continuous Monitoring of O2
Sat
● Hemorrhage
● Death
DIAGNOSTIC TESTS AND MANAGEMENT
ECG
UTZ (Monthly monitor fetal growth)
Non-Stress Test ( Monitor for actual status)
MGT (Meds): Vasodilators (Hydralazine, Methyldopa, Digoxin [first line of treatment to improve CO
● Enables blood flow between the left & right atria
via the interatrial septum → tissue that divides the
right & left atria
● Pregnancy is well tolerated w/ uncomplicated
ASD
ATRIAL SEPTAL DEFECT
ACQUIRED CARDIAC DISEASES
● Rheumatic Heart Disease
● Mitral Stenosis
● Mitral Valve Prolapse
● Peripartum and Postpartum Cardiomyopathy
LEFT-TO-RIGHT SHUNT (Acyanotic)
● Atrial Septal Defect
● Ventricular Septal Defect
● Patent Ductus Arteriosus
RIGHT-TO-LEFT SHUNT (Cyanotic)
● TOF (Tetralogy of Fallot)
● Eisenmenger Syndrome
1.)
● Hole located in the middle
● Most common
2.) Hole located near the bottom of atrial septum
3.) Close to superior vena cava and right atrium
1.) Ostium Secundum
2.) Ostium Primum
3.) Ostium Primum
● Happens when an opening between the two
bottom chambers (ventricles) of the heart is
present.
● More common than ASD.
● Detected & corrected before childbearing age Ventricular Septal Defect.
VENTRICULAR SEPTAL DEFECT
● Caused by the failure to close off the ductus
arteriosus after birth.
● Usually discovered & treated in childhood.
PATENT DUCTUS ARTERIOSUS
Most common cyanotic heart disease present
during pregnancy; & the primary cause of
right-to-left shunting of blood.
Combination of 4 defects
✩ Ventricular septal defect
✩ Pulmonary valve stenosis
✩ Right ventricular hypertrophy
✩ Displacement of the aorta
MANAGEMENT: Surgical repair pre-pregnancy pulmonary valve replacement (Homograft).
TETRALOGY OF FALLOT
● Localized narrowing of the aorta near the insertion
of the ductus arteriosus.
● An example of an acyanotic congenital heart lesion
● Hypertension/increased pulse rate in the upper
extremities but hypotension/low pulse rate in the lower
extremities
COARCTATION OF THE AORTA
● Results when recurrent inflammation from bouts of
rheumatic fever causes scarring formation on the
valves, resulting to stenosis & regurgitation
● Damage from untreated Rheumatic Fever, caused
by Group A beta-hemolytic streptococcal throat
infection or URT infections
Mitral valve is the common site for stenosis
RHEUMATIC HEART DISEASE
● A consequence of rheumatic fever.
● Narrowing of the opening of the mitral valve caused
by stiffening of valve leaflets, which obstructs
blood flow from the atrium to the ventricle.
MITRAL STENOSIS
● The mitral valve leaflets prolapsed into the left
atrium during ventricular systole, allowing some
backflow of blood.
MITRAL VALVE PROLAPSE
A dysfunction of the LV that occurs in the last
month of pregnancy or the 1 st 5 months
postpartum in a woman with no previous history of
heart disease.
PERIPARTUM AND POSTPARTUM
CARDIOMYOPATHY
defined as a disease condition which is
caused by reduced blood flow in a coronary
artery due to atherosclerosis and occlusion of an
artery by an embolus or thrombus.
MYOCARDIAL INFARCTION
● Characterized as right to left sided atrial or
ventricular septal defect with accompanying
pulmonary stenosis.
● Develops when pulmonary resistance equals or
exceeds systemic resistance to blood flow.
EISENMENGER SYNDROME
Meds prescribed: WITH CHRONIC HYPERTENSIVE
VASCULAR DISEASE
β-Blockers
calcium channel blockers
Labetalol (Trandate)
Nifedipine (Procardia)
PREVENT INCREASED CARDIAC WORKLOAD
● Avoiding excessive WEIGHT GAIN & ANEMIA
● Avoid exertion
○ Modify approaches to activities to regulate
energy expenditures & reduce cardiac workload.
ANTICOAGULANTS
● Subcutaneous Heparin & Enoxaparin (Lovenox) or
IV Heparin
● Warfarin (Coumadin) is restricted (if pregnant)
● Avoid foods high in Vit. K such as raw dark leafy
vegetables because Vit K is an antidote to an
anticoagulant.
