Cardiovascular Disorders and Pregnancy Flashcards
Peripartum heart disease is rare (true or false)
true
Most common CVDs in pregnancy(4)
- valve damage caused by rheumatic fever or Kawasaki disease
- Atrial septal defect or uncorrected coarctation of the aorta (congenital anomalies)
- Aortic dilation from Marfan syndrome
- Coronary artery disease (CAD) and varicosities (advanced age)
Blood volume increase during pregnancy:
30%-50%
Most dangerous time
week 28 to 32
(CLASSIFICATION of HEART DISEASE)
Ordinary physical activity causes no discomfort. No symptoms
of cardiac insufficiency and no anginal pain.
Uncompromised.
(CLASSIFICATION of HEART DISEASE)
Ordinary physical activity causes excessive fatigue,
palpitation, and dyspnea or anginal pain.
Slightly compromised.
(CLASSIFICATION of HEART DISEASE)
Woman is unable to carry out any physical activity
without experiencing discomfort. Even at rest, symptoms of cardiac
insufficiency or anginal pain are present.
Severely compromised.
(CLASSIFICATION of HEART DISEASE)
During less than ordinary activity, woman experiences
excessive fatigue, palpitations, dyspnea, or anginal pain.
Markedly compromised.
- Mitral stenosis, mitral insufficiency, aortic coarctation
- Left ventricle cannot move large volume of blood, causing distention (left side), lowered CO, and pulmonary hypertension
- Thrombus formation from noncirculating blood
Left-Sided Heart Failure
When pulmonary vein reaches 25 mmHg, fluid leaks into the interstitial space into and surrounding alveoli
pulmonary edema
suddenly waking at night short of breath
paroxysmal nocturnal dyspnea
Distention of liver and spleen in right-sided heart failure lead to
– dyspnea and pain
congenital anomaly most apt to cause right-sided heart failure in women of reproductive age
Eisenmenger Syndrome
occurs when the output of the right ventricle is less than the blood volume received by the right atrium from the vena cava
Right-Sided Heart Failure
- Caused by pulmonary valve stenosis, Eisenmenger syndrome, -
- right-to-left atrial or ventricular septal defect
Right-Sided Heart Failure
Congestion of systemic venous circulation
- __cardiac output to the lungs
- __ BP in the aorta
- __ BP in the vena cava
- ↓cardiac output to the lungs
- ↓ BP in the aorta
- ↑ BP in the vena cava
Distention of abdominal and lower extremity vessels – lead to exudate of fluid from vessels into the peritoneal cavity or called?
ascites
- May be caused by the stress of pregnancy in the circulatory system
- Mortality: as high as ____%
Peripartum Heart Disease
50%
Preterm labor – ?
Poor placental perfusion – ?
immature fetus
late deceleration
Tx for peripartum heart disease
- reduce physical activities
- diuretics
- arrhythmia agent
- digitalis therapy
- heparin
Interventions: Prepartum
- Promote rest
- Promote healthy nutrition
- Educate regarding medication
- Educate regarding avoidance of infection
- Be prepared for emergency actions
Interventions: Intrapartum
- Monitor VS, uterine contractions
- Side-lying to reduce supine hypotension
- If with pulmonary edema – semi-fowler’s
- O2 administration
- Epidural anesthesia (anesth. Of choice) – to decrease sensation of pushing
Interventions: Postpartum
- Decreased activity
- Anticoagulant and digoxin therapy
- Antiembolic stockings
- Prophylactic antibiotics
- Stool softener
Management of Artificial Valve Prosthesis
- Low-molecular-weight heparin before and during pregnancy
- Observe pt. for petechiae and premature separation of placenta
