Pregnancy Flashcards
Normal exam
Mild jvp
Mild pedal edema
S3
Systolic ejection murmur
Arrhythmias
You can cardiovert
Abnormal
S4 Holosystolic murmur Fixed S2 Rales Diastolic murmur
Stenosis lesions tolerated poorly
Regurgitant and vsd tolerated well
Increase risk of thrombosis
20% arterial
80% venous
Congenital heart disease
20% maternal complications
Maternal cardiac risk
Previous cardiac events
NYHA >2 or cyanosis
Lvef 30
High risk pregnancy
Mechanical valve Systemic RV Fontan Aortic dilatation 40-45 in Marfan Aortic dilatation 45-50 in bicuspid
No pregnancy
Pah Severe LV dysfunction Previous post partum cardiomyopathy Severe as and ms Mar fans with aorta >45 Bucuspid with aorta >50 Coarctation
Post partum cardiomyopathy
Risk Multiple gestation Advanced age Pregnancy induced HTN Tocolytic therapy
HTN
Pregnancy and HTN increases risk of long term vascular complications
Marfan and pregnancy o
Cousel Strict bp control Monthly echo Class 2 C section Replace the root >4 cm
Endocarditis
Fetal mortality 15-30%
Maternal 11-33%
Coumadin
Pregnancy
Ok to use in 2-3 trimester for mechanical valves
May DC and use UFA during delivery
Add Asa for all prosthetic valves during pregnancy
If you have to use Coumadin in the first trimester do not cross 5 mg dose
Mi
Pregnancy
Fatality 5-37%
HTN age>30,sepsis,transfusions, smoking
