Heart Disease Flashcards
(40 cards)
What is the commonest indirect cause of maternal mortality
Heart disease & RTA
What is the commonst cause of maternal mortality (Direct)
Ectopic, hemorrhage, pre-eclampsia and eclampsia
What are the commenst heart diseases during the reproductive age?
Coronary artery, conginital, and rheumatic heart disease
Why is hypertension,diabetes and obesity are Common during pregnancy?
Because women are getting pregnant in their late 30s
Why are females less likely to develop CAD?
Effect of estrogen
Why is Rh heart disease more common in saudi
Infections and reluctance to use Ab
When does the cardiac output during preg increase and when is the peak?
In the 1st trimester, peaks in 32 (30-50%)
What is the normal CO in females and males (not pregnant)
5L
What is the CO by 32 weeks (approximate)
4L > 6L
What are the causes for increased CO?
- early preg: increase SV
- late preg: increase HR
- decreased (peripheral resistance\viscosity)
Why is there decreased blood viscosity?
To maintan BP from increasing (causes hypotension)
How does physiological anemia usually develop?
- relative increase in plasma volume
- increase in RBC mass
> > decrease in viscosity
How is the physiological anemia (increased plasma and decreased RBC volume) a protective factor?
1- Because if there’s bleeding, then the blood lost will be mostly diluted
2- to increase the O2 carrying capacity
3- decrease thrombosis
What are the classes and grading of functional capacity of the heart?
1: No limit - sx w\extra activity
2: mild limit - sx w\ordianry acitvity
3: marked limit - sx w\less ordinary
4: severe limit - sx w\rest
What are the clinical features in normal pregnancy that can mimic cardiac disease
1- dyspnea 2- pedal edema 3- cardiac impulse (Displaced apex) 4- JV distension 5- ESM in left sternal boarder
Why is dyspnea present in normal pregnancy?
Hyperventilation due to elevated diaphragm
What are cardiac impulses usually seen in normal pregnancy
Diffused, shifted laterally from the elevated diaphragm
Why is ESM commonly heard in pregnancy
Increased flow through aortic and pulmonary valves
What do you expect to see in the ECG of pregnant women (That could be misleading but are normal)
Ectopics, Qwave, inveted T wave, ST depression, QRS left shift
What do you expect to see in the CXR of pregnant women (That could be misleading but are normal)
Increased vascular markings & slight cardiomegaly
What are the criteria to diagnose a cardiac disease during pregnancy
1- diastolic murmurs
2- severe systolic murmurs (grade 3)
3- unequivocal enlargment of heart On CXR
4- severe arrythemia, Afib or flutter
What are the signs and symptoms indicating heart disease
Dyspnea, orthpnra, PND, Hemoptysis, syncope, chest pain, cyanosis, clubbing, presistant vein distension, loud diastolic murmus, cardiomargaly and arrythmia
Name low risk cardiac lesions of maternal mortality
1- septal defect
2- Class 1 and 2 NYHA
3- PDA
4- pulmonary and tricuspid lesions
Name moderate risk cardiac lesions of maternal mortality
1- NYHA class 3 and 4 2- aortic stenosis 3- marfan’s syndrome With normal aorta 4- uncomplicated COA 5- past hx of MI
