Cardiac disease in pregnancy and arrhythmias

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Cardiac disease in pregnancy Microchapters

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Overview

Pathophysiology

Epidemiology and Demographics

Risk Factors

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Exercise Testing

Radiation Exposure

Chest X Ray

Echocardiography

MRI

CT

Catheterization:

Pulmonary artery catheterization
Cardiac catheterization
Cardiac Ablation

Treatment

Cardiovascular Drugs in Pregnancy

Labor and delivery

Resuscitation in Late Pregnancy

Contraindications to pregnancy

Special Scenarios:

I. Pre-existing Cardiac Disease:
Congenital Heart Disease
Repaired Congenital Heart Disease
Pulmonary Hypertension
Rheumatic Heart Disease
Connective Tissue Disorders
II. Valvular Heart Disease:
Mitral Stenosis
Mitral Regurgitation
Aortic Insufficiency
Aortic Stenosis
Mechanical Prosthetic Valves
Tissue Prosthetic Valves
III. Cardiomyopathy:
Dilated Cardiomyopathy
Hypertrophic Cardiomyopathy
Peripartum Cardiomyopathy
IV. Cardiac diseases that may develop During Pregnancy:
Arrhythmias
Acute Myocardial Infarction
Hypertension

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Although underlying reasons remain unclear, if a woman has a prior history of arrhythmias, the risk of recurrent arrhythmias may increase during pregnancy.[1] [2] [3] Unfortunately drugs that are effective in the management of arrhythmias such as amiodarone can present a hazard to the fetus during pregnancy.

Arrythmias

Supraventricular Tachycardia During Pregnancy

Ventricular Tachycardia During Pregnancy

Acute VT

Recurrent VT

Anti-arrhythmic Drugs to Avoid During the Pregnancy

Anti-arrhythmic Drugs to Avoid During Lactation

  • Secreted in breast milk
  • It becomes concentrated in breast milk. Infants receive much larger doses.
  • Neonatal bradycardia
  • Neonatal hypoglycemia

Related Chapters

References

  1. Tawam M, Levine J, Mendelson M, Goldberger J, Dyer A, Kadish A. Effect of pregnancy on paroxysmal supraventricular tachycardia. Am J Cardiol 1993; 72: 838-40.
  2. Brodsky M, Doria R, Allen B, Sato D, Thomas G, Sada M. New-onset ventricular tachycardia during pregnancy. Am Heart J 1992; 123: 933-41.
  3. Chow T, Galvin J, McGovern B. Antiarrhythmic drug therapy in pregnancy and lactation. Am J Cardiol 1998; 82 (4A): 58I - 62I.
  4. 4.0 4.1 4.2 Onuigbo M, Alikhan M. Over-the-counter sympathomimetics: a risk factor for cardiac arrhythmias in pregnancy. South Med J 1998; 91: 1153-5.
  5. Eliahou HE, Silverberg DS, Reisin E, Romem I, Mashiach S, Serr DM. Propranolol for the treatment of hypertension in pregnancy. Br J Obstet Gynaecol 1978;85:431-6.
  6. Lydakis C, Lip GY, Beevers M, Beevers DG. Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens 1999; 12:541-7.


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