Maternal Cardiac Care

Maternal Cardiac Care

A Guide to Managing Pregnant Women with Heart Disease

1st Edition - July 3, 2022

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  • Authors: John Wilson, William Schnettler, Adam Lubert, Gruschen Veldtman, Andrea Girnius
  • Hardcover ISBN: 9780323824644
  • eBook ISBN: 9780323824651

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Description

Heart disease is currently the leading cause of maternal mortality in developed countries and is expected to increase further due to advanced maternal age and conditions such as type 2 diabetes. Maternal Cardiac Care: A Guide to Managing Pregnant Women with Heart Disease is an up-to-date, multidisciplinary resource for physicians and advanced practice nurses caring for pregnant patients with a variety of preexisting and emerging cardiac issues.

Table of Contents

  • Cover image
  • Title page
  • Table of Contents
  • Any screen, Any time, Anywhere
  • Copyright
  • Dedication
  • Preface
  • Acknowledgements
  • Contributors
  • Unit I: Normal Pregnancy
  • 1. Physiologic Adaptations to Pregnancy
  • Abstract
  • Cardiovascular System
  • Respiratory System
  • Hematologic and Immune Systems
  • Renal System
  • Gastrointestinal System
  • Placenta
  • Bibliography
  • 2. The Cardiac Physical Examination in Pregnancy
  • Abstract
  • Respiratory Rate and Pattern
  • Chest Wall
  • Lung Sounds
  • Pulse
  • Blood Pressure
  • Jugular Venous Pressure
  • Apical Impulse
  • Heart Sounds
  • Murmurs
  • Extremities
  • Bibliography
  • 3. Obstetric Care for Nonobstetricians
  • Abstract
  • Bibliography
  • Unit II: Pregnancy in Women With Heart Disease
  • 4. Prepregnancy Counseling
  • Abstract
  • Prepregnancy Counseling: An Overview
  • Risk-Assessment Scoring Systems and Tests
  • Bibliography
  • 5. Cardiac Conditions That May Affect Pregnancy
  • Abstract
  • Hypertension
  • Postpartum Hypertension
  • Congenital Heart Disease
  • Pulmonary Hypertension
  • Increased Risk for Thrombosis
  • Left Ventricular Dysfunction
  • Right Ventricular Dysfunction
  • Cyanotic Congenital Heart Disease
  • Valvular Lesions
  • Morbid Obesity
  • Pulmonic Stenosis
  • Pulmonic Regurgitation
  • Tricuspid Stenosis
  • Tricuspid Regurgitation
  • Mixed Valvular Disease
  • Prosthetic Heart Valves
  • Baffles, Shunts, and Conduits
  • Bibliography
  • 6. Obstetric Events That Affect Cardiac Patients
  • Abstract
  • Antenatal Period
  • Peripartum Period
  • Postpartum Period
  • Analgesia and Anesthesia
  • Assisted Delivery
  • Cesarean Delivery
  • Deep Vein Thrombosis
  • Multiple-Gestation Pregnancies
  • Preeclampsia and Eclampsia
  • Bibliography
  • 7. Managing Specific Cardiac Conditions During Pregnancy, Labor, and Delivery
  • Abstract
  • Aortic Dissection
  • Aortic Regurgitation
  • Aortic Stenosis
  • Arrhythmogenic Right Ventricular Cardiomyopathy
  • Atrial Septal Defect
  • Atrioventricular Canal Defects
  • Coarctation of the Aorta
  • Cor Pulmonale and Lung Disease
  • Coronary Artery Disease
  • Dilated Cardiomyopathy Preceding Pregnancy
  • Double-Outlet Right Ventricle
  • Ebstein’s Anomaly
  • Ehlers-Danlos Type IV (Vascular Type)
  • Hypertrophic Cardiomyopathy
  • Inappropriate Sinus Tachycardia
  • Kawasaki Disease
  • Left Ventricular Noncompaction
  • Loeys-Dietz Syndrome
  • Marfan Syndrome
  • Mitral Regurgitation
  • Mitral Stenosis
  • Myocardial Infarction
  • Pericardial Disease
  • Peripartum Cardiomyopathy
  • Peripheral Edema
  • Patent Ductus Arterriosus
  • Postural Orthostatic Tachycardia Syndrome
  • Pulmonary Atresia
  • Pulmonary Hypertension
  • Pulmonary Valve Regurgitation
  • Pulmonic Stenosis
  • Single Ventricle
  • Systemic Lupus Erythematosus
  • Takotsubo Cardiomyopathy
  • Tetralogy of Fallot
  • Transpositon of the Great Arteries
  • Tricuspid Atresia
  • Tricuspid Regurgitation
  • Tricuspid Stenosis
  • Vasovagal Syncope
  • Ventricular Septal Defects
  • Bibliography
  • Unit III: Specific Cardiac Conditions Encountered in Pregnant Women
  • 8. Peripartum Cardiomyopathy
  • Abstract
  • Incidence and Risk Factors
  • Diagnosis
  • Proposed Etiologies and Pathophysiology
  • Treatment
  • Prognosis
  • Bibliography
  • 9. Endocarditis in Pregnancy
  • Abstract
  • Incidence and Risk Factors
  • Diagnosis
  • Treatment
  • Bibliography
  • 10. Arrhythmias During Pregnancy
  • Abstract
  • Overview: Arrhythmias
  • Specific Arrhythmias: Diagnosis and Management
  • Bibliography
  • Antiarrhythmic Drugs
  • Atrial Fibrillation
  • Atrial Flutter
  • Cardioversion
  • Long QT Syndromes
  • Palpitations
  • Supraventricular Tachycardia
  • Ventricular Tachycardia
  • Ventricular Fibrillation
  • Wolf Parkinson White Syndrome
  • 11. Fetal Tachycardia
  • Abstract
  • Diagnosis
  • Treatment
  • Bibliography
  • Unit IV: Pharmacology
  • 12. An Overview: Pharmacology During Pregnancy
  • Abstract
  • Volume of Distribution
  • Protein Binding
  • Absorption
  • Metabolism
  • Effects on the Fetus
  • Bibliography
  • 13. The Use of Cardiac Drugs During Pregnancy
  • Abstracts
  • Acute Coronary Syndromes and Postoperative Care
  • Angina
  • Arrhythmias
  • Heart Failure
  • Hypertension
  • Breastfeeding
  • Bibliography
  • 14. Anticoagulation During Pregnancy
  • Abstract
  • Bibliography
  • 15. Cardiac Effects of Drugs Commonly Used in Obstetrics
  • Abstract
  • Unit V: Anesthesia
  • 16. Cardiac Effects of Anesthetic Agents That May Be Used in Labor and Delivery
  • Abstract
  • Medications for Neuraxial Anesthesia
  • Medications for General Anesthesia
  • Bibliography
  • 17. Anesthesia for Cardiac Patients During Labor and Delivery
  • Abstract
  • Cardiac Changes During Labor and Delivery
  • The Basics of Neuraxial Anesthesia and Analgesia
  • Analgesia for Vaginal Delivery
  • Anesthesia for Cesarean Section
  • Bibliography
  • 18. Anesthesia for Nonobstetric Procedures During Pregnancy
  • Abstract
  • Timing of Surgery
  • Anesthetic Preevaluation
  • Selection of Anesthetic Method
  • Anesthetic Considerations During Surgery
  • Teratogenic Effects of Anesthetic Agents
  • Induction and Maintenance of Anesthesia
  • Positioning
  • Placental Transfer of Anesthetic Medications
  • Cardiac Surgery During Pregnancy
  • Fetal Monitoring During Surgery
  • Bibliography
  • Unit VI: Evaluation and Intervention for Cardiac Conditions During Pregnancy
  • 19. Cardiac Testing During Pregnancy
  • Abstract
  • Cardiac Magnetic Resonance Imaging Scan
  • Chest Radiography
  • Computed Tomography Scan
  • Electrocardiogram
  • Graded Exercise Testing
  • Holter Monitor and Other Wearable Event Recorders
  • Implantable Loop Recorders
  • Stress Echocardiography
  • Dobutamine Stress Echocardiography
  • Radionuclide Investigations
  • Transesophageal Echocardiography
  • Transthoracic Echocardiography and Doppler
  • Bibliography
  • 20. Cardiac Intervention During Pregnancy
  • Abstract
  • Bibliography
  • Aortic Balloon Valvuloplasty
  • Mitral Balloon Valvuloplasty
  • 21. Cardiac Surgery During Pregnancy
  • Bibliography
  • 22. Cardiac Arrest in Pregnancy
  • Abstract
  • Overview: Cardiac Arrest in Pregnancy
  • Advanced Cardiac Life Support
  • Perimortem Cesarean Section
  • Postarrest Targeted Temperature Management
  • Bibliography
  • Unit VII: The Management Team and the Management Plan
  • 23. The Maternal Cardiac Care Team and the Maternal Cardiac Care Facility
  • Abstract
  • Need for Maternal Cardiac Care Programs
  • Patient Management Team
  • Patient Management Process
  • Maternal Cardiac Care Facilities
  • Bibliography
  • 24. Assessment of Maternal Risk and Assessment of Fetal Risk
  • Abstract
  • Maternal Risk Assessment
  • Fetal Risk Assessment
  • Bibliography
  • 25. The Patient Management Plan
  • Abstract
  • 26. Nursing Considerations
  • Abstract
  • Overview of Nursing Standards
  • Multidisciplinary Care
  • Nursing Education
  • Bibliography
  • Unit VIII: Miscellaneous
  • 27. Pregnancy After Heart Transplant
  • Abstract
  • Overview
  • Prepregnancy Counseling
  • Pregnancy Risks
  • Pregnancy Management
  • Contraception
  • Pregnancy After Heart/Lung Transplant
  • Bibliography
  • 28. COVID-19 in Pregnant Patients
  • Abstract
  • Overview
  • Signs and Symptoms
  • Management
  • Delivery Considerations
  • Bibliography
  • 29. Breastfeeding
  • Abstract
  • Bibliography
  • Amiodarone
  • Amlodipine
  • Angiotensin-Converting Enzyme Inhibitors
  • Angiotensin Receptor Blockers
  • Antiplatelet Drugs (Clopidogrel, Ticlopidine)
  • Aspirin
  • Atenolol
  • Bisoprolol
  • Clonidine
  • Digoxin
  • Diltiazem
  • Doxazosin
  • Flecainide
  • Heparin
  • Hydralazine
  • Hydrochlorothiazide
  • Labetalol
  • Loop Diuretics
  • Low-Molecular-Weight Heparin
  • Methyldopa
  • Metoprolol
  • Nifedipine
  • Nitrates
  • Procainamide
  • Propafenone (no data on safety)
  • Propranolol
  • Quinidine
  • Sotalol
  • Spironolactone
  • Statins
  • Warfarin
  • 30. Contraception
  • Abstract
  • High-Risk Patient Populations
  • Birth Control Methods
  • Bibliography
  • 31. Termination of Pregnancy
  • Abstract
  • Medical Abortion
  • Surgical Abortion
  • Anesthetics and Other Considerations
  • Bibliography
  • 32. Infertility Treatment
  • Abstract
  • Assisted Reproductive Technologies
  • In Vitro Fertilization Health Risks and Other Considerations
  • Bibliography
  • 33. Genetic Counseling
  • Abstract
  • Overview: Genetic Counseling
  • Risk Assessment
  • Ellis-Van Creveld Syndrome
  • Holt-Oram Syndrome
  • Kartagener Syndrome
  • Leopard Syndrome
  • Marfan Syndrome
  • Noonan Syndrome
  • Other Genetic Disorders
  • Bibliography
  • 34. Substance Abuse in Pregnancy
  • Abstract
  • Tobacco
  • Alcohol
  • Opioids
  • Cocaine
  • Amphetamines
  • Marijuana
  • Bibliography
  • 35. The Placenta
  • Abstract
  • Placental–Maternal Communication
  • Placenta and Fetal Outcomes
  • Substance Abuse and the Placenta
  • Congenital Vascular Dysfunction
  • Bibliography
  • Appendix. Normal Lab Values In Pregnancy
  • Index
  • Confidence is ClinicalKey

Product details

  • No. of pages: 208
  • Language: English
  • Copyright: © Elsevier 2022
  • Published: July 3, 2022
  • Imprint: Elsevier
  • Hardcover ISBN: 9780323824644
  • eBook ISBN: 9780323824651

About the Authors

John Wilson

Dr. Wilson is a cardiologist/electrophysiologist who has practiced clinical electrophysiology for 30 years. For many years he was the director of electrophysiology and section head of cardiology at Good Samaritan Hospital in Cincinnati. He is board certified in cardiology and electrophysiology, and he trained in both at the Cleveland Clinic. He has a long-standing interest in obstetrics.

William Schnettler

Dr. Schnettler is a board-certified maternal-fetal medicine specialist and director of the TriHealth Center for Maternal Cardiac and Critical Care. His research and clinical focus lie in deepening the underlying physiologic adaptation to pregnancy among women with cardiac and critical illness.

Adam Lubert

Dr. Lubert is an Assistant Professor of Paediatrics at the University of Cincinnati and a board-certified adult congenital cardiologist practicing at Cincinnati Children's Hospital. He staffs the pregnancy clinics at the University of Cincinnati's Cardiac Care in Pregnancy Clinic and the Good Samaritan Hospital's Center for Maternal Cardiac Care clinic.

Affiliations and Expertise

Assistant Professor Adult Congenital Heart Disease

Gruschen Veldtman

Dr. Veldtman is an Adult Congenital Heart Disease (ACHD) specialist, previously Director of the University of Cincinnati ACHD program and Fontan Management clinic. He now leads the ACHD program in Riyadh King Faisal Specialist Hospital and Research Center

Affiliations and Expertise

Adult Congenital Heart Disease, KFSH&RC Cincinnati Children's Hospital Medical Center

Andrea Girnius

Dr. Girnius is a practicing board-certified anesthesiologist who is fellowship trained in both cardiac and obstetric anesthesiology. She completed her training at Brigham and Women’s Hospital and at the University of Cincinnati, and currently, she practices at the University of Cincinnati. Her primary clinical and academic focus lies in the safe obstetric and anesthetic care of pregnant women with cardiac disease. She is the primary anesthesiologist for the University of Cincinnati’s Cardiac Care in Pregnancy Clinic.

Affiliations and Expertise

Assistant Professor of Clinical Anesthesiology University of Cincinnati Medical Center Department of Anesthesiology

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