Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Domain 3 : Obstetrics > ESC Guidelines On Cardiac Diseases In Pregnancy > Flashcards

ESC Guidelines On Cardiac Diseases In Pregnancy Flashcards

1
Q

Peripartum Cardiomyopathy : Risk factors

A 
°Multiparity
°Africa Ethnicity 
°Smoking 
° Diabetes 
° Pre-eclampsia 
° Malnutrition 
° Advanced maternal age
° Teen Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Peripartum Cardiomyopathy : causes

A

° Inflammation
° Angiogenic imbalance
They induce vascular damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peripartum Cardiomyopathy : Biological factors

A

° Biological active 16 kDa prolactin, fms like tyrosine kinase
May initiate PPCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Peripartum Cardiomyopathy : presentation

A

Heart failure 2° to LV systolic dysfunction

May present with arrhythmia and/ cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Peripartum Cardiomyopathy : Diagnosis

A

Echocardiography: LVEF < 30%
MARKED LV dilatation LVEDD>6.0cm
RV Involvement associated with adverse outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PPCM: prognosis

A 
SA 12,6% affects 1:1000 15-50% morta
Germany 2.0%
Turkey 24%
If EF does not recover > 50% future pregnancy should be discouraged.
Recurrence highly possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dilated Cardiomyopathy : definition

A

LV dilatation and dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Dilated Cardiomyopathy : causes

A 
Viral infection
Drugs
Ischaemia
Idiopathic 50%
Hereditary 25-35%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dilated Cardiomyopathy : stats

A

Prevalence of idiopathic 1:25000

SA 1:1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dilated Cardiomyopathy : prognosis

A

Predictors of mortality

  • NYHA iii/iv
  • EF < 20%
  • MR
  • RV failure
  • AF
  • Hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dilated Cardiomyopathy : Prepregnancy counselling and MX

A

Modification of antifailure RX : stop ACEI, ARBS, AR I, MRAs

Cont Blocker selective B1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management of HF in pregnancy: acute/subacute HF

A

Pulmonary Congestion : thiazide + loop diuretic

HPT: Hydralazin, nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of HF in pregnancy : haemodynamicaly u stable & cardiogenic shock

A

Transfer to center with mechanical circulatory support team
Urgent delivery c/s irregardless of gestational age
Avoid Blockers especially in PPCM
Levosimendin ideal ionotrope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bromocriptine PPCM

A

Dose 2,5mg daily for 1/52 in uncomplicated cases
2,5mg bd 6/52 EF<25% / cardiogenic shock
Start anticoagulant LMWH/UFH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of HF in pregnancy : haemodynamicaly u stable & cardiogenic shock: Devices

A

Start with wearable ICD 3-6m if no recovery ICD and cardiac resynchronization devices LBBB QRS>130ms
Transplant if mechanical support not possible or no recovery 6-12m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HF in pregnancy : heart Transplant

A

Avoid pregnancy 1st yearconsi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

HF in pregnancy : anticoagulant

A

Consider if low EF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

HF In pregnancy : delivery and breastfeed

A

CS if haemodynamicaly unstable

No BF if HFrEF or NYHA iii/iv

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

AHF DURING PREGNANCY flow chart

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Recommendation forx of Cardiomyopathy and HF In pregnancy

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

AHF in pregnancy MX flow chart

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hypertrophic Cardiomyopathy in pregnancy incidence

A

<1:1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

HOCM in pregnancy mortality rate

A

0.5% mortality and 29% if symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HOCM in pregnancy fetal mortality rate

A

Spontaneous abortion 15%
Therapeutic abortion 5%
Still birth 2%
Premature birth 26%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
HOCM in pregnancy mortality risk factors
Symptoms Prepregnancy Diastolic dysfunction Severe LV outflow track obstruction Arrhythmia
26
HOCM in pregnancy post partum cardiac event risk factors
CARPREG OR ZAHARA> 1 | Medication in pregnancy period
27
HOCM in pregnancy symptoms
HF with pulmonary Congestion | Echo diagnostic
28
HOCM in pregnancy management frequency of reviews
WHO I reviewed per trimester | WHO III review monthly/ bimonthly
29
HOCM in pregnancy management AF
Rate control Supress VA Verapramil drug of choice when Blocker not tolarated Cardioversion if unstable persistent AF
30
HOCM in pregnancy management hypovolaemia
Not well tolarated
31
HOCM in pregnancy management Anticoagulant
Therapeutic if paroxysmal or persistent arrhythmia
32
HOCM in pregnancy management Sudden cardiac death
If symptomatic palpitations and/ syncope device insertion recommended
33
HOCM in pregnancy management Delivery
``` C/S if LV outflow tract obstruction No single shot spinal Monitor BR rhythm Oxytocin given slow infusion IVF judiciously ```
34
Arrhythmia in pregnancy : maternal risk
AF increases mortality risk SCK ^ eisk Congenital LQTS Brady arrhythmia amd conduction disturbances better outcomes
35
Arrhythmia in pregnancy : obs and offspring risk
PSVT worse outcome for both
36
Arrhythmia in pregnancy : SVT
Adinosine drug of choice RX BBlocker except atenolol ideal or Verapramil prevention except in WPW Consider flecainide, propafenone(not in IHD), sotalol if 1st line drugs fail rate control
37
Arrhythmia in pregnancy : AFib AFlu
Electrical conversation if unstable AF preceded by anticoagulant Bitilide or flecainide if stable AF/flutter Rate control with BBlocker In CHD Cardioversion recommended
38
Arrhythmia in pregnancy : VT
39
Arrhythmia in pregnancy : Brady arrhythmia
Sinus node dysfunction : rare related to hypotensive syndrome of pregnancy supine MX lateral decubitus or pacemaker if persistent AV block: associated with poor outcomes esp Narrow QRS complex MX ventricular pacing if symptomatic
40
Arrhythmia in pregnancy intervention : electrical Cardioversion
Safe Can induce fetal arrhythmia Monitor fetal HR after conversion
41
Arrhythmia in pregnancy intervention : catheter ablation
Postpone to 2nd tri if possible
42
Arrhythmia in pregnancy intervention : ICD + pacemaker
Prepregnancy insertion in SCM Radiation risk Safety done > 8/52
43
Arrhythmia surveillance recommendations
44
Recommendation for arrhythmia in pregnancy
45
Coronary artery disease in pregnancy : etiology
``` Smoking Hypertensive Diabetes mellitus Dyslipidemia Thrombophilia Advanced maternal age Obesity Pre-eclampsia Postpartum infection Cocain PPH Multiparity ```
46
coronary artery disease in pregnancy : presentation
3rd tri | Similar presentation with none pregnancy
47
Coronary artery disease in pregnancy : Diagnosis
Difficult ecg as in inverted t wave a normal occurrence High troponins suggestive Echo helpful
48
Coronary artery disease in pregnancy : differentials
PE Aortic dissection Pre-eclampsia
49
Coronary artery disease in pregnancy : Complications
``` HF 38% Arrhythmia 12% Recurrent MIor angina 20% Maternal Mortality 7% Foetal death 7% ```
50
Coronary artery disease in pregnancy : management
Multidisciplinary | Similar to none pregnant individuals
51
Cad : intervention
Drug elutng Stent ideal | Asprin and P2Y12 inhibitor monitor bleeding
52
Pre existing CAD
Mortality 0-23% | 12 months post intervention
53
CAD labour and delivery
Individuals MX Postpone 2/52 post AMI Vaginal delivery preferred
54
AF I in pregnancy recommendation
55
Modification WHO classification of maternal cardiovascular risk
I no risk II small risk of complications III high risk IV pregnancy contraindicated
56
Predictors maternal and Neonatal events
57
General recommendations
58
Risk stratification CARPREG 1
59
CARPREG 2
60
ZAHARA
61
WHO classification
62
WHO classification
63
Obstetric consideration s
High risk Planned delivery mostly vaginal Scheduled induction
64
Cardiac vaginal delivery
Complete Cervical dilation No pushing Uterus labours down Vacuum/forceps assisted delivery
65
Why no phusing?
Vasalva causes increased intrathoracic pressure,increase afterload, reduction in preload and overshoot of CO that occurs upon release and can predispose to acute heart failure.
66
Which condition can attempt cardiac nvd?
``` Pulmonary hypertension Fixed stenotic lesion Single ventricle Ventricular dysfunction Moderate degree of aortic dilation ```
67
Monitoring requirements for cardiac vaginal delivery
Pulse oximeter 5 lead ECG A-line No cvp/pac
68
What labour analgesia can be used for cardiac vaginal delivery
CSE- intrathecal opioid CSE DURA puncture epidural
69
Consideration for CSE/epidural in cardiac vaginal delivery
LOR saline especially shunts Replace ineffective catheter early No adrenaline
70
Aim of labour analgesia
Sympathetic block avoiding increase HR BP
71
Regimen
Bupivacaine 4-5mg Bupivacaine and fent 20-25mcg over 15-20min T6 surgical level
72
RISI vs cardiac induction
73
Additional monitoring
Cvp | Tee
74
Pharmacological considerations oxytocin
Oxytocin | Prostaglandin
75
Pharmacological considerations prostaglandin for alpha
76
Pharmacological considerations ergometrine
77
Pharmacological considerations tocolytics
78
Pharmacological considerations antiHPT
79
Pharmacological considerations anticoagulants mx
80
Postpartum
``` HC/ICU Analgesia Haemodynamic monitoring Anticoagulants reinitiation monitoring Multidisciplinary mx ```

Domain 3 : Obstetrics (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions