ductus arteriosisĬlinical Indicators of Heart Disease during Pregnancy Symptoms: Ĭlinical Indicators of Heart Disease during Pregnancy Signs Cyanosis Clubbing of fingers Persistent neck vein distension Systolic murmur grade≥ 3/6 Diastolic murmur Cardiomegaly Persistent arrhythmia Pregnant women who have none of these findings rarely have serious heart disease.ĭiagnostic Study & Normal Pregnancy Findings ECG: 15° left-axis deviation Echocardiography: Tricuspid regurgitation and significantly increased left-atria size and left-ventricular outflow cross sectional area Chest X’ray: heart silhouette is larger in pregnancy however, gross cardiomegaly can be excluded. Prominent pulsation of the neck veins.Dyspnea : ↑HR, consciousness of breathing (progesterone).patient under digitalis has less prognosis than those of the same functional class without treatment)ĭiagnosis of Heart Disease The physiological adaptations of normal pregnancy can induce symptoms and signs that may be confused with that of heart disease. Existing complications that increase the cardiac load such as stress, infection and high effort.Increase fetal congenital HD (from 0.6% to 4.5%) if the mother has CHD.So a small family, while young, with 2-3 years spacing is advised before progression of the lesions. 4-Pregnancy induced low vascular resistance may improve the symptoms of MR, AR & MV prolapse.
3-Bacterial endocarditis due to infection by streptococcus viridans in the valves and myocardium.
During pregnancy: Precipitated by increased cardiac output especially with anemia (at 28-32 weeks).Past history of similar attacks unless first presentation.Ĭonfirmed by: reversibility following bronchodilator treatment, and symptomatic response to treatment.Effect of Pregnancy on Heart Disease 1.Decompensation (heart failure):
Other specific triggers to breathlessness. Spirometry: reduced FEV, reduced FEV1/FVC ratio, <12% reversibility, hypoxia ± increased arterial PCO (rarely, reduced α 1-antitrypsin levels). Reduced peak flow rate.Ĭonfirmed by: CXR: radiolucent lungs. Pursed lip breathing, use of accessory muscles, reduced breath sounds, wheezes. Suggested by: smoking history, cough and sputum. Abnormal ECG reflecting underlying heart disease Impaired left ventricular (LV) function on echocardiogram. Suggested by: dyspnoea, displaced apex beat, third heart sound, bilateral basal fine crackles.Ĭonfirmed by: CXR appearances. Pulmonary oedema due to congestive (chronic) left ventricular failure Differential diagnosis for orthopnea and paroxysmal nocturnal dyspnoea (PND)Ĭommon and important causes of orthopnoea and paroxysmal nocturnal dyspnoea (PND) for doctors and medical students Diagnosis
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