Pregnancy and Heart Disease, An Issue of Cardiology Clinics

1st Edition, Volume 39-1 - November 23, 2020
Editors: Melinda Davis, Kathryn Lindley
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 8 0 9 2 6 - 9
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 0 9 2 7 - 6

This issue of Cardiology Clinics, curated by Dr. Melinda Davis and Dr. Kathryn Lindley, will explore topics related to Pregnancy and Heart Disease. This issue is one of four… Read more

Pregnancy and Heart Disease, An Issue of Cardiology Clinics

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This issue of Cardiology Clinics, curated by Dr. Melinda Davis and Dr. Kathryn Lindley, will explore topics related to Pregnancy and Heart Disease. This issue is one of four selected each year by the series editorial board: Jamil A. Aboulhosn, David M. Shavelle, Terrence D. Welch, and Audrey H. Wu. Topics in this volume include, but are not limited to, Cardiovascular Contribution to Maternal Mortality, Risk stratification and The Pregnancy Heart Team, Cardiovascular Testing in Pregnant Women, Obstetric Considerations and Delivery Planning, Adult Congenital Heart Disease, Aortopathies and Vascular Disease, Arrhythmias, Hypertensive Disorders of Pregnancy, Ischemic Heart Disease, Pulmonary Arterial Hypertension, Peripartum Cardiomyopathy¸ Hypertrophic Cardiomyopathy, Valvular Heart Disease, Medication Safety during Pregnancy, and Delivering Coordinated Care from Preconception through Postpartum.

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Preface
Cardiovascular Contribution to Maternal Mortality
Key points
Introduction
Cardiovascular complications and adverse maternal outcomes
Future directions
Clinics care points
The Importance of Cardiovascular Risk Assessment and Pregnancy Heart Team in the Management of Cardiovascular Disease in Pregnancy
Key points
Introduction
Physiologic changes in pregnancy
Components of antenatal risk assessment
Components of postpartum risk assessment and follow-up
Role of multidisciplinary pregnancy heart team
Summary
Clinics Care Points
Cardiovascular Testing and Imaging in Pregnant Women
Key points
Introduction
Biomarkers
Cardiac diagnostic testing
Tests that Use Ionizing Radiation
Summary
Clinics care points
Cardiovascular Medications in Pregnancy: A Primer
Key points
Introduction
Physiologic changes in pregnancy
Maternal pharmacokinetic alterations during pregnancy
Placental contribution to pharmacokinetics
Classification of cardiovascular medications
Antiarrhythmic therapies
Anticoagulation and antiplatelet therapy
Hypertensive disorders and preeclampsia: recommended treatment
Summation
Pregnancy in Women with Adult Congenital Heart Disease
Key points
Introduction
Preconception counseling
Prenatal care
Labor and delivery
Postpartum care and follow-up
Specific lesions
Summary
Clinics care points
Arrhythmias and Pregnancy: Management of Preexisting and New-Onset Maternal Arrhythmias
Key points
Background
Pathophysiology
Premature beats
Supraventricular tachycardia
Atrial fibrillation
Inappropriate sinus tachycardia
Ventricular tachycardia
Bradyarrhythmias
Diagnosis and management
Pharmacotherapy
Direct current cardioversion
Electrophysiology procedures
Summary
Clinics care points
Hypertensive Disorders of Pregnancy
Key points
Background and epidemiology
Normal physiologic response to pregnancy
Measuring blood pressure in pregnancy
Diagnosing and classifying hypertension in pregnancy
Treatment of hypertensive disorders during pregnancy
Primary and secondary prevention of preeclampsia
Choice of antihypertensive medications in pregnancy
Treatment of severe-range hypertension and hypertensive emergencies in pregnancy
The fourth trimester
Hypertensive disorders during pregnancy and future cardiovascular risk
Summary
Clinics care points
Ischemic Heart Disease in Pregnancy
Key points
Introduction
Pathophysiology
Prevalence and type of myocardial infarction in pregnancy
Preexisting Ischemic heart disease
Acquired ischemic heart disease during pregnancy
Summary and future directions
care. Clinics points
Pulmonary Arterial Hypertension in Pregnancy
Key points
Introduction
Pathophysiology
Hemodynamics of pregnancy and pulmonary arterial hypertension
Management
Outcomes
Summary
Peripartum Cardiomyopathy
Key points
Introduction
Case definition
Epidemiology
Pathophysiology, genetics, and risk factors
Diagnosis
Biomarkers
Treatment
Outcomes
Subsequent pregnancy
Additional clinical concerns
Summary
Clinics care points
Hypertrophic Cardiomyopathy in Pregnancy
Key points
Introduction
Preconception genetic testing
Pathophysiology related to pregnancy
Preconception clinical evaluation and risk assessment
Management during pregnancy
Delivery
Summary
Clinics care points
Valvular Heart Disease in Pregnancy
Key points
Introduction
Preconception counseling
Risk assessment
Delivery considerations
Specific valve lesions
Mitral regurgitation and aortic regurgitation
Pulmonic stenosis
Pulmonic regurgitation
Tricuspid regurgitation
Prosthetic valves
Summary
Clinics care points
Acknowledgments
Delivering Coordinated Cardio-Obstetric Care from Preconception through Postpartum
Key points
Introduction
Preconception
Pregnancy and peripartum
Postpartum
Cardio-obstetrics team: what has been achieved and what remains to be achieved
Summary
Clinics Care Points