Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Valvular Heart Disease > Heart Disease in Pregnancy > Flashcards

Heart Disease in Pregnancy Flashcards

1
Q

What percentage of pregnancies in the United States are affected by cardiovascular disease (CVD)?

A

1–4%

CVD includes congenital heart disease, acquired heart disease, and myocardial diseases.

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

What are the most common causes of maternal death worldwide?

A

Hemorrhage and hypertensive disorders of pregnancy

Hypertensive disorders occur in 6–8% of all pregnancies.

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

What has happened to maternal deaths attributed to cardiovascular conditions in the United States since 2006?

A

They have increased

This increase contrasts with decreases in deaths due to hemorrhage, hypertensive disorders of pregnancy, and anesthesia complications.

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

What is now the leading cause of maternal death in the United States and the United Kingdom?

A

Cardiomyopathy

Cardiomyopathy specifically has become the top cause.

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

What was the overall US maternal mortality ratio in 2014?

A

17.2 per 100,000 births

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

How does maternal age influence pregnancy-related mortality ratios?

A

They increase with maternal age

25% of all maternal deaths occur in women older than 35 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most common form of CVD seen in pregnancy in the United States and western Europe?

A

Congenital heart disease (CHD)

CHD accounts for about 80% of CVD cases and 20% of maternal deaths.

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

What is the prevalence of rheumatic heart disease (RHD) as a cause of CVD in pregnancy in developing countries?

A

60–90%

RHD is the most common cause of CVD in pregnancy outside Europe and North America.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens to systemic vascular resistance (SVR) during pregnancy?

A

It declines by 35–40%

The decrease in SVR is detectable by the fifth week of gestation.

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

What physiological changes occur in the maternal cardiovascular system during pregnancy?

A

Increase in stroke volume and heart rate

Stroke volume increases to a maximum of 40% above baseline by 34 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the average increase in cardiac output during pregnancy according to a meta-analysis?

A

1.5 L/min (31%)

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

What is the modified World Health Organization (WHO) risk classification used for?

A

Maternal risk assessment in women with CVD

It incorporates known maternal risk factors and contraindications to pregnancy.

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

What are the four classes of the modified WHO risk classification?

A

Class I, Class II, Class II to III, Class III

Class I has no detectable increased risk, while Class III has a higher risk.

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

What are the 4 predictors of an adverse maternal cardiac event identified by CARPREG?

A
  • Left heart obstruction
  • History of a cardiac event
  • Cyanosis or NYHA functional class III or IV
  • Systolic ventricular function <40%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the risk of adverse cardiac events in pregnancies with 0, 1, and >1 CARPREG points?

A

3%, 39%, and 66%

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

What is the most prevalent obstetric complication in the ZAHARA cohort?

A

Hypertensive complications (12.2%)

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

True or False: The CARPREG score is the most widely used maternal risk score for assessing women with CVD.

A

True

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

What additional independent predictors of adverse cardiac complications during pregnancy were identified in the ZAHARA study?

A
  • Mechanical heart valve
  • Severe left heart obstruction
  • History of arrhythmias
  • History of cardiac medication use before pregnancy
  • History of cyanotic heart disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a ventricular septal defect (VSD)?

A

A congenital heart defect characterized by an opening in the ventricular septum, allowing blood to flow between the left and right ventricles.

VSDs are common congenital heart defects that can lead to increased pulmonary blood flow.

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

What are the follow-up recommendations for patients with repaired tetralogy of Fallot (TOF)?

A

Cardiology follow-up is recommended every trimester.

Regular follow-up is essential to monitor for any complications or changes in heart function.

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

What defines modified WHO risk class II conditions?

A

Conditions that can fall either into class II or III depending on individual circumstances.

Examples include native or tissue valvular heart disease, repaired coarctation, and mild left ventricular dysfunction.

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

What are the recommendations for modified WHO risk class III conditions?

A

Expert counseling is recommended to individualize maternal and fetal risk in pregnancy.

Conditions include mechanical valve, systemic right ventricle, and complex congenital heart disease.

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

What is the chance of live birth for women with cyanosis and prepregnancy resting arterial oxygen saturation <85%?

A

12% chance of a live birth.

This highlights the significant risk associated with severe cyanosis during pregnancy.

24
Q

What defines modified WHO risk class IV conditions?

A

Cardiac conditions in which pregnancy is contraindicated due to extremely high risk of maternal mortality or severe morbidity.

If pregnancy occurs, termination is advised.

25
Q

What is the fetal complication rate for pregnancies in women with cardiovascular disease (CVD)?

A

20–25% of pregnancies may experience fetal or neonatal complications.

This includes issues such as death, preterm delivery, and decreased birth weight.

26
Q

What are maternal predictors of fetal complications in pregnancies with CVD?

A

Maternal NYHA functional class III or IV, left heart obstruction, mechanical heart valves, anticoagulation use, smoking, and maternal age <20 or >35 years.

These factors significantly affect fetal outcomes.

27
Q

What is pulmonary hypertension defined as?

A

A mean pulmonary artery pressure at rest >25 mmHg or >30 mmHg on exercise in the absence of a left-to-right shunt.

Mild pulmonary arterial hypertension is defined as a pulmonary artery systolic pressure of ~36–50 mmHg.

28
Q

What is Eisenmenger syndrome?

A

The triad of systemic-to-pulmonary shunt, pulmonary arterial hypertension, and cyanosis.

It is the most severe form of shunt-related pulmonary hypertension.

29
Q

What are the risks associated with pregnancy in women with Eisenmenger syndrome?

A

Pregnancy is contraindicated due to a high risk of maternal mortality from sudden arrhythmia-related death and progressive heart failure.

Termination is recommended for pregnancies in these women.

30
Q

What are some cyanotic congenital lesions without pulmonary hypertension?

A

Unrepaired TOF, pulmonary atresia with aortopulmonary collaterals, and Ebstein’s anomaly.

These conditions can lead to significant maternal and fetal risks.

31
Q

What is the most important predictor of fetal outcome in cyanotic heart disease?

A

The degree of maternal hypoxemia.

Maternal oxygen saturation levels significantly influence fetal survival rates.

32
Q

What is the prevalence of atrial septal defects (ASDs) in live births?

A

Approximately 2 per 1000 live births.

ASDs are among the most common congenital heart defects.

33
Q

What type of ASD is most common?

A

Secundum ASD, which accounts for 70% of ASDs.

Secundum ASDs are more common in females than males.

34
Q

What are the risks associated with ventricular septal defects (VSDs) during pregnancy?

A

Increased maternal risk of heart failure and arrhythmias, especially with large VSDs and pulmonary hypertension.

Most small VSDs are well tolerated in pregnancy.

35
Q

What is the prevalence of atrioventricular septal defects (AVSDs) in live births?

A

0.3–0.4 per 1000 live births.

AVSDs are strongly associated with Down syndrome.

36
Q

What are Atrioventricular (AV) septal or AV canal defects?

A

A complex congenital heart defect involving the development of the endocardial cushion, associated with defects involving the AV valves and the AV septum.

37
Q

What is the prevalence of Atrioventricular Septal Defects (AVSD)?

A

Approximately 0.3–0.4 per 1000 live births.

38
Q

What genetic condition is strongly associated with AVSD?

A

Down syndrome (trisomy 21).

39
Q

What are the two types of AV canal defects?

A
  • Complete AV canal defect
  • Incomplete AV canal defect
40
Q

What is a common complication associated with AV canal defects?

A

AV valve regurgitation.

41
Q

What are the consequences of complete AV canal defects?

A
  • Left-to-right shunting at both atrial and ventricular levels
  • Early heart failure
  • Pulmonary hypertension
42
Q

What is the WHO risk category for women with moderate or less residual AV valve regurgitation and normal left ventricular function after repair?

A

WHO category risk II.

43
Q

What is Coarctation of the aorta?

A

A significant narrowing of the proximal thoracic aorta at the insertion of the ductus arteriosum.

44
Q

What are the potential complications of untreated coarctation of the aorta?

A
  • Systemic hypertension
  • Early coronary artery disease
  • Stroke
  • Heart failure
  • Aneurysm formation
  • Aortic dissection and rupture
45
Q

What condition is commonly associated with coarctation of the aorta?

A

Bicuspid aortic valve (BAV).

46
Q

What is the recommended action for significant coarctation or recurrent coarctation before pregnancy?

A

Correction of the coarctation.

47
Q

What percentage of congenital heart defects does pulmonary valve disease account for?

A

7%.

48
Q

What are the types of pulmonary stenosis?

A
  • Valvular
  • Subvalvular
  • Supravalvular
49
Q

What symptoms may indicate severe pulmonary stenosis?

A
  • Exercise-induced fatigue
  • Dyspnea
  • Syncope
  • Chest pain
50
Q

What is Ebstein’s anomaly?

A

A congenital developmental defect involving the tricuspid valve and the right ventricle.

51
Q

What is a common association found in 80% of Ebstein’s anomaly cases?

A

Patent foramen ovale (PFO) or secundum ASD.

52
Q

What are the four components of Tetralogy of Fallot (TOF)?

A
  • Malpositioned aorta overriding the ventricular septum
  • Large malaligned VSD
  • Infundibular subpulmonary pulmonary stenosis
  • Right ventricular hypertrophy
53
Q

What is the prevalence of Tetralogy of Fallot?

A

About 4–5 per 10,000 live births.

54
Q

What is Transposition of the Great Arteries (TGA)?

A

A congenital heart defect where the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle.

55
Q

What is the most common form of TGA?

A

Dextro-TGA (d-TGA).

56
Q

What determines the physiology and prognosis in TGA?

A

Orientation of the ventricles.

57
Q

What are the risks associated with Ebstein’s anomaly during pregnancy?

A
  • Arrhythmias
  • Right heart failure
  • Premature delivery
  • Fetal mortality

Valvular Heart Disease (13 decks)

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