Maternal Medical Diseases Flashcards
1
Q
List four physiologic changes that impact management of cardiac disease in pregnancy.
A
Decreased SVR
Hypervolemia
Increased CO
Hypercoagulability
2
Q
What cardiac exam findings can be normal in pregnancy, yet pathologic outside of pregnancy?
A
Mammary souffle Venous hum Increased JVP Split S2 S3 Flow murmur
3
Q
What clinical findings are suggestive of heart disease in pregnancy?
A
Progressive dyspnea/orthopnea Nocturnal cough Hemoptysis Syncope Chest pain Cyanosis Clubbing Persistent neck vein distention Systolic murmur > 2/6 Diastolic murmur Cardiomegaly Persistent arrhythmia Persistent split S2 Criteria for pHTN
4
Q
List three common ECG findings in pregnancy.
A
LAD
PACs
PVCs
5
Q
List three common echocardiogram findings in pregnancy.
A
Mild TR
Increased LA end-diastolic dimension
Increased LV mass
6
Q
What are four predictors of cardiac complications in pregnancy?
A
Prior HF, TIA, arrhythmia, or CVA
NYHA III/IV or cyanosis
Left-sided obstruction
EF < 40%
7
Q
What are the cardiac indications for CS?
A
Aortic root > 4 cm dilated Aortic aneurysm Acute severe CHF Recent MI Severe symptomatic AS Warfarin within previous 2 weeks Possible need for emergency valve replacement following CS
