Cardiovascular Complications of Pregnancy
Cardiomyopathy of Pregnancy (Peripartum Cardiomyopathy) In approximately one of 4000–15,000 patients, dilated cardiomyopathy develops in the final month of pregnancy or within 6 months after delivery. The cause is unclear, but immune and viral causes have been postulated. The disease occurs more frequently in women over age 30 years, is generally related to the first or second pregnancy, and is associated with gestational hypertension and drugs used to stop uterine contractions. The course of the disease is variable; many cases improve or resolve completely over several months, but others progress to refractory heart failure. About 60% of patients make a complete recovery. Immunosuppressive therapy has been advocated, but few supportive data are available. Recently, -blockers have been administered judiciously to these patients, with at least anecdotal success. Some advocate anticoagulation because of an increased risk for thrombotic events. Recurrence in subsequent pregnancies is common, particularly if cardiac function has not recovered.
Coronary Artery & Other Vascular Abnormalities
There have been a number of reports of myocardial infarction during pregnancy. It is known that pregnancy predisposes to dissection of the aorta and other arteries, perhaps because of the accompanying connective tissue changes. The risk may be particularly high in patients with Marfan or Ehlers-Danlos syndromes. However, coronary artery dissection is responsible for only a minority of the infarctions; most are caused by atherosclerotic CAD or coronary emboli. Most of the events occur near term or shortly following delivery, and paradoxical emboli through a PFO has been implicated in some cases. Clinical management is essentially similar to that of other patients with acute infarction, unless there is a connective tissue disorder. If nonatherosclerotic dissection is present, coronary intervention is risky as further dissection can be aggravated. In most instances, conservative management is warranted. Thanks for our attention for Cardiovascular Complications of Pregnancy article.
There have been a number of reports of myocardial infarction during pregnancy. It is known that pregnancy predisposes to dissection of the aorta and other arteries, perhaps because of the accompanying connective tissue changes. The risk may be particularly high in patients with Marfan or Ehlers-Danlos syndromes. However, coronary artery dissection is responsible for only a minority of the infarctions; most are caused by atherosclerotic CAD or coronary emboli. Most of the events occur near term or shortly following delivery, and paradoxical emboli through a PFO has been implicated in some cases. Clinical management is essentially similar to that of other patients with acute infarction, unless there is a connective tissue disorder. If nonatherosclerotic dissection is present, coronary intervention is risky as further dissection can be aggravated. In most instances, conservative management is warranted. Thanks for our attention for Cardiovascular Complications of Pregnancy article.