Cardiac disease in pregnancy chest x ray

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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]; Lakshmi Gopalakrishnan, M.B.B.S. [3]

Overview

Performance of routine chest x-rays should be avoided, especially in the first trimester of pregnancy. A chest x ray may be indicated in the pregnant patient with dyspnea [1] or cough [1]. Among patients with dyspnea, a chest x-ray may be obtained to eavluate the patient for the presence of heart failure due to peripartum cardiomyopathy. In this scenario, the chest x ray may show cardiomegaly, Kerley B lines, pleural effusion and cephalization of blood vessels.

Chest X Ray

Normal Chest X-Ray Findings During Pregnancy

A normal chest x-ray during normal pregnancy may reveal physiologic changes such as increased left ventricular dimension and cardiomegaly, which in the absence of dyspnea is usually secondary to the elevation of diaphragm and should be interpreted with caution.

Precautions

The preferable estimated fetal exposure from ionizing radiation should be kept below 50 mGy and with chest x-ray, the exposed radiation is <0.01 mGy.[1][2] Although the theoretical risk of irradiation to the fetus is low, the pelvic area should be shielded if chest x-ray is performed and the radiation dose should be documented in the medical record.[3]

References

  1. 1.0 1.1 1.2 "ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy". Obstetrics and Gynecology. 104 (3): 647–51. 2004. PMID 15339791. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  2. Damilakis J, Theocharopoulos N, Perisinakis K, Manios E, Dimitriou P, Vardas P, Gourtsoyiannis N (2001). "Conceptus radiation dose and risk from cardiac catheter ablation procedures". Circulation. 104 (8): 893–7. PMID 11514375. Retrieved 2012-04-17. Unknown parameter |month= ignored (help)
  3. Osei EK, Faulkner K (1999). "Fetal doses from radiological examinations". The British Journal of Radiology. 72 (860): 773–80. PMID 10624343. Retrieved 2012-04-18. Unknown parameter |month= ignored (help)


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