Pulmonary Hypertension and Pregnancy.

Pulmonary Hypertension and Pregnancy. Obstet Gynecol. 2019 Oct 08;: Authors: Martin SR, Edwards A Abstract Pulmonary hypertension is a term used to describe a complex multifactorial group of conditions diagnosed by an elevated mean pulmonary artery pressure of 20 mm Hg or higher on right heart catheterization. The diagnosis of pulmonary hypertension in pregnancy is important, as it is associated with high rates of maternal morbidity and mortality, even with modern management. Diagnostic testing is important for establishing the diagnosis, type, and severity of pulmonary hypertension, which in turn, dictates treatment options. Echocardiographic assessment is the first step in diagnosis and the gold standard for monitoring right heart function in patients with pulmonary hypertension. Supportive therapy for pulmonary hypertension includes monitored exercise, vaccination, and avoidance of certain activities. Therapies for pulmonary hypertension are considered conventional or targeted. Conventional therapy includes preventative care, anticoagulation, and calcium channel blockers for appropriate patients. Targeted therapy is usually reserved for patients with World Health Organization group 1 pulmonary arterial hypertension (including idiopathic, heritable, drug-induced or associated with congenital heart disease) and involves different types of direct pulmonary vasodilators. Right heart failure is the end result of pulmonary hypertension and the options for m...
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research

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Publication date: Available online 11 September 2019Source: JACC: Heart FailureAuthor(s): Karen Sliwa, Lucia Baris, Christoph Sinning, Elvin Zengin-Sahm, Lina Gumbiene, Israa F. Yaseen, Ghada Youssef, Mark Johnson, Hasan Al-Farhan, Malgorzata Lelonek, Roger Hall, Jolien Roos-HesselinkAbstractObjectivesThe purpose of this work was to study maternal and fetal outcomes of women with uncorrected congenital heart disease (CHD).BackgroundGlobally, CHD is an important cause of maternal morbidity and mortality in women reaching reproductive stage. Data are lacking from larger cohorts of women with uncorrected CHD.MethodsThe 10-yea...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
Publication date: Available online 11 September 2019Source: JACC: Heart FailureAuthor(s): Karen Sliwa, Lucia Baris, Christoph Sinning, Elvin Zengin-Sahm, Lina Gumbiene, Israa F. Yaseen, Ghada Youssef, Mark Johnson, Hasan Al-Farhan, Malgorzata Lelonek, Roger Hall, Jolien Roos-HesselinkAbstractBackgroundGlobally, congenital heart disease (CHD) is an important cause of maternal morbidity and mortality in women reaching reproductive stage. There is lack of data from larger cohorts of women with uncorrected CHD.ObjectivesTo study maternal and fetal outcome of women with uncorrected CHD.MethodsAn analysis of 10-year data from th...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
This study demonstrated that the incidence of ischemic heart disease and death were three times higher among men with low birth weight compared to men with high birth weight (5). Epidemiological investigations of adults born at the time of the Dutch famine between 1944 and 1945 revealed an association between maternal starvation and a low infant birth weight with a high incidence of hypertension and coronary heart disease in these adults (23). Furthermore, Painter et al. reported the incidence of early onset coronary heart disease among persons conceived during the Dutch famine (24). In that regard, Barker's findin...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
This Medicine MCQ Test Series contains 20 questions which can be attempted over 40 seconds each. After submission, answers and discussion will be displayed. Medicine MCQ Test Series 1 Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Medicine MCQ - CVS Source Type: blogs
Purpose of review To discuss the risk preexisting or new onset cardiomyopathy/heart failure (CMP/heart failure) in pregnant woman, and recent insights regarding their management and therapy. Recent findings Recent data from the European Registry on Pregnancy and Heart disease of the European Society of Cardiology (ROPAC) suggest that, after an adequate prepregnancy evaluation in specialized centres, the vast majority of pregnancies are safe for both mother and foetus. A tailored approach is required according to cardiac phenotype (i.e. type of cardiomyopathy), clinical and functional status, and new potential treatmen...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research
It is needless to say that heart disease in pregnancy is a challenge for the obstetrician and the cardiologist. Hemodynamic changes in pregnancy and labour can adversely affect many of the significant cardiac lesions. Increase in blood volume and heart rate are the important factors during pregnancy. In general stenotic lesions and pulmonary hypertension are poorly tolerated, while regurgitant lesions are better tolerated. Specific risks like aortic dissection and rupture are there for coarctation of aorta. Several risk stratification schemes have been developed for assessing the risk of pregnancy with heart disease over ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology CARPREG II risk scoring CARPREG risk stratification mWHO classification ZAHARA risk score Source Type: blogs
In this report, the authors present the successful experience of management of severe mitral stenosis in pregnancy. PMID: 29746039 [PubMed - in process]
Source: Clinical and Experimental Obstetrics and Gynecology - Category: OBGYN Tags: Clin Exp Obstet Gynecol Source Type: research
Authors: Niwa K Abstract The number of women with congenital heart disease (CHD) at risk of pregnancy is growing because over 90% of them are grown-up into adulthood. The outcome of pregnancy and delivery is favorable in most of them provided that functional class and systemic ventricular function are good. Women with CHD such as pulmonary hypertension (Eisenmenger syndrome), severe left ventricular outflow stenosis, cyanotic CHD, aortopathy, Fontan procedure and systemic right ventricle (complete transposition of the great arteries [TGA] after atrial switch, congenitally corrected TGA) carry a high-risk. Most freq...
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
Purpose of review: To define the magnitude of problems faced by patients with adult congenital heart disease (ACHD) and to identify unmet needs for this population. Recent findings: The ACHD population is estimated to include more than 1 million people in the United States and continues to grow at a steady rate. Owing to the decline in early mortality in this group, modern medicine is now faced by the long-term complications associated with congenital heart disease such as chronic heart failure, increased endocarditis risk, elevated burden of arrhythmias, pulmonary hypertension, valvular dysfunction, and pregnancy. Summa...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: IMAGING ADULTS WITH CONGENITAL HEART DISEASE: Edited by Sherif Nagueh Source Type: research
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