Pregnancy and cardiac diease Flashcards
Test 2
During pregnancy, on average how much does blood volume increase
50%
Majority of blood volume increase occurs during which trimester?
1st
CO increases by _____% due to increased SV and a slight increase in HR (10bpm)
30-50%
Red cell and plasma volume _____ (increase/decrease)
Increase
In pregnancy and heart disease it is common to see:
- SOB
- Exercise intolerance
- Fatigue
- Third heart sound
- Low-grade systolic ejection murmur
(last two are due to increased CO)
Pregnancy poses the highest maternal and fetal morbidity and mortality for patients who have:
- Sig. obstructive valvular lesions
- Pulmonary hypertension
- Sig. pathology of the thoracic Ao
- Class III or IV heart failure
- Uncontrolled hypertension
Patients should avoid or terminate pregnancy because of high risk to maternl or fetal morbidity and mortality:
- Pulmonary HTN w/PA systolic pressure > 70 mmHg
- Symptomatic obstructive lesions
- Marfan’s Syndrome w/dilated Ao
- DCM w/heart failure
Peripartum Cardiomyopathy
The development of dilated cardiomyopathy of unexplained etiology, resulting in CHF, which is temporarily related to gestational period
Causes of peripartum cardiomyopathy
- Myocarditis of viral or immune origin
- Nutritional deficiency
- Small vessel CA disease
- Hormonal effects
- Toxemia
HTN during pregnancy is an increase in systolic BP of ____mmHg or more or an increase in diastolic BP of _____mmHg or more
- 30 mmHg
- 15 mmHg
Chronic HTN is BP more than ____mmHg before pregnancy or before 20 wks or that persists longer than 6 wks postpartum
135/85 mmHg
Pre-eclampsia/Eclampsia:
The development of HTN after more than 20 wks gestation that is accompanied by proteinuria or edema, or both
______ is the leading cause of maternal death in developed countries
Pulmonary embolism
What causes an increase in lower extremity DVT
Anatomic venous stasis caused by uterine compression
What is recommended in high risk patients for venous thromboembolic disease (lower extremity DVT)
Prophylaxis (anticoagulation)
Condtions that require antibiotic prophylaxis during complicated vaginal delivery or in the presence of infection:
- Unrepaired VSD
- Residual VSD or PDA after repair
- Valvular stenosis
- Ao coarc (repaired or not)
- h/o bacterial endocarditis
- Comlpex cyanotic heart disease
- Prosthetic valve (bioprosthetic or homograft)
- Pulmonary shints or conduits put in by surgical repair
- Bicuspid AoV
- Acquired valvular dysfunction
- HOCM
- MVP w/regurg or thick leaflets
Since plasma increases more, it results in?
Physiologic anemia
When does peripartum cardiomyopathy usually occur?
1 mo before childbirth to 6 mo after
HTN during pregnancy is an _____ in systolic BP of 30 mmHg or more or an _____ in diastolic BP of 15 mmHg or more (increase/decrease)
Increase
Increase
