Cardiac disease in pregnancy medical therapy

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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

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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]

Antibiotic Prophylaxis

The official American Heart Association (AHA) recommendation is that antibody prophylaxis is not necessary for an uncomplicated delivery except among patients with a prosthetic heart valve or surgically constructed systemic to pulmonary shunt. However, because of the difficulties in predicting complicated deliveries and the potential devastating consequences of endocarditis, antibiotic prophylaxis for vaginal delivery in all patients with congenital heart disease expect those with an isolated secundum type atrial septal defect and those six months or more after repair of septal defects or surgical ligation division of a patent duct is arteriosus, seems reasonable. At the time of delivery it is recommended that all women with valvular heart disease receive antibiotics, usually penicillin and gentamycin. For those with a pencillin allergy, vancomycin is used.

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