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Current Cardiology Reviews

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ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

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General Review Article

Cardiovascular Diseases in Pregnancy - A Brief Overview

Author(s): Ankit Kumar Sahu*, Mullusoge Mariappa Harsha and Sonika Rathoor

Volume 18, Issue 1, 2022

Published on: 25 August, 2021

Article ID: e250821195824 Pages: 12

DOI: 10.2174/1573403X17666210825103653

Price: $65

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Abstract

Even though, there have been many advances in maternal medical care and fertility treatments, the presence of cardiovascular disease has a significant impact on pregnancy. In pregnant women, several heart conditions, such as valvular heart disease, chronic hypertension, congenital heart defects and non-ischemic cardiomyopathies are linked to increased risk of fetal as well as maternal morbidity and mortality. To date, the management of the co-existing conditions of pregnancy and heart disease has been challenging. Therefore, in-depth information may be beneficial to tackle a difficult case scenario. Towards this end, this paper provides an overview of the recent updated knowledge of pregnancy-related cardiovascular diseases in women.

Keywords: Physiological adaptation, cardiovascular hemodynamics, multidimensional approach, feto-maternal safety, risk assessment.

Graphical Abstract

[1]
Fretts RC, Schmittdiel J, McLean FH, Usher RH, Goldman MB. Increased maternal age and the risk of fetal death. N Engl J Med 1995; 333(15): 953-7.
[http://dx.doi.org/10.1056/NEJM199510123331501] [PMID: 7666913]
[2]
Laws PJ, Sullivan DE, Grayson N. Australia's mothers and babies 2007: AIHW National Perinatal Statistics Unit Sydney. 2004.
[3]
Yassin K, Elfil AM, Hamid H. Epidemiology of cardiac disease during pregnancy in Khartoum Hospital, Sudan. J Womens Health Care 2015; 4(2): 227-30.
[4]
Kuklina E, Callaghan W. Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995-2006. BJOG 2011; 118(3): 345-52.
[http://dx.doi.org/10.1111/j.1471-0528.2010.02743.x] [PMID: 21091604]
[5]
Drenthen W, Pieper PG, Roos-Hesselink JW, et al. Outcome of pregnancy in women with congenital heart disease: A literature review. J Am Coll Cardiol 2007; 49(24): 2303-11.
[http://dx.doi.org/10.1016/j.jacc.2007.03.027] [PMID: 17572244]
[6]
Drenthen W, Boersma E, Balci A, et al. Predictors of pregnancy complications in women with congenital heart disease. Eur Heart J 2010; 31(17): 2124-32.
[http://dx.doi.org/10.1093/eurheartj/ehq200] [PMID: 20584777]
[7]
Shime J, Mocarski EJ, Hastings D, Webb GD, McLaughlin PR. Congenital heart disease in pregnancy: short- and long-term implications. Am J Obstet Gynecol 1987; 156(2): 313-22.
[http://dx.doi.org/10.1016/0002-9378(87)90275-4] [PMID: 3826166]
[8]
Burlew BS. Managing the pregnant patient with heart disease. Clin Cardiol 1990; 13(11): 757-62.
[http://dx.doi.org/10.1002/clc.4960131103] [PMID: 2272132]
[9]
Pritchard JA. Changes in the blood volume during pregnancy and delivery. Anesthesiology 1965; 26: 393-9.
[http://dx.doi.org/10.1097/00000542-196507000-00004] [PMID: 14313451]
[10]
Metcalfe J, Ueland K. Maternal cardiovascular adjustments to pregnancy. Prog Cardiovasc Dis 1974; 16(4): 363-74.
[http://dx.doi.org/10.1016/0033-0620(74)90028-0] [PMID: 4368892]
[11]
McFaul PB, Dornan JC, Lamki H, Boyle D. Pregnancy complicated by maternal heart disease. A review of 519 women. Br J Obstet Gynaecol 1988; 95(9): 861-7.
[http://dx.doi.org/10.1111/j.1471-0528.1988.tb06570.x] [PMID: 3191059]
[12]
Robson SC, Hunter S, Boys RJ, Dunlop W. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989; 256(4 Pt 2): H1060-5.
[PMID: 2705548]
[13]
Katz R, Karliner JS, Resnik R. Effects of a natural volume overload state (pregnancy) on left ventricular performance in normal human subjects. Circulation 1978; 58(3 Pt 1): 434-41.
[http://dx.doi.org/10.1161/01.CIR.58.3.434] [PMID: 679433]
[14]
Robson SC, Hunter S, Moore M, Dunlop W. Haemodynamic changes during the puerperium: A Doppler and M-mode echocardiographic study. Br J Obstet Gynaecol 1987; 94(11): 1028-39.
[http://dx.doi.org/10.1111/j.1471-0528.1987.tb02286.x] [PMID: 3322367]
[15]
Thorne S, MacGregor A, Nelson-Piercy C. Risks of contraception and pregnancy in heart disease. Heart 2006; 92(10): 1520-5.
[http://dx.doi.org/10.1136/hrt.2006.095240] [PMID: 16973809]
[16]
Bowater SE, Thorne SA. Management of pregnancy in women with acquired and congenital heart disease. Postgrad Med J 2010; 86(1012): 100-5.
[http://dx.doi.org/10.1136/pgmj.2008.078030] [PMID: 20145059]
[17]
Siu SC, Sermer M, Colman JM, et al. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation 2001; 104(5): 515-21.
[http://dx.doi.org/10.1161/hc3001.093437] [PMID: 11479246]
[18]
Carruth JE, Mivis SB, Brogan DR, Wenger NK. The electrocardiogram in normal pregnancy. Am Heart J 1981; 102(6 Pt 1): 1075-8.
[http://dx.doi.org/10.1016/0002-8703(81)90497-X] [PMID: 7315707]
[19]
Sadaniantz A, Kocheril AG, Emaus SP, Garber CE, Parisi AF. Cardiovascular changes in pregnancy evaluated by two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 1992; 5(3): 253-8.
[http://dx.doi.org/10.1016/S0894-7317(14)80345-3] [PMID: 1622616]
[20]
Umazume T, Yamada T, Yamada S, et al. Morphofunctional cardiac changes in pregnant women: Associations with biomarkers. Open Heart 2018; 5(2): e000850.
[http://dx.doi.org/10.1136/openhrt-2018-000850] [PMID: 30057771]
[21]
Tanous D, Siu SC, Mason J, et al. B-type natriuretic peptide in pregnant women with heart disease. J Am Coll Cardiol 2010; 56(15): 1247-53.
[http://dx.doi.org/10.1016/j.jacc.2010.02.076] [PMID: 20883932]
[22]
Marcus FI, Ewy GA, O’Rourke RA, Walsh B, Bleich AC. The effect of pregnancy on the murmurs of mitral and aortic regurgitation. Circulation 1970; 41(5): 795-805.
[http://dx.doi.org/10.1161/01.CIR.41.5.795] [PMID: 5429489]
[23]
Hass JM. The effect of pregnancy on the midsystolic click and murmur of the prolapsing posterior leaflet of the mitral valve. Am Heart J 1976; 92(3): 407-8.
[http://dx.doi.org/10.1016/S0002-8703(76)80125-1] [PMID: 949036]
[24]
Association NYH. Diseases of the heart and blood vessels: nomenclature and criteria for diagnosis. Little, Brown 1964.
[25]
Damilakis J, Theocharopoulos N, Perisinakis K, et al. Conceptus radiation dose and risk from cardiac catheter ablation procedures. Circulation 2001; 104(8): 893-7.
[http://dx.doi.org/10.1161/hc5790.094909] [PMID: 11514375]
[26]
Barton JR, O’brien JM, Bergauer NK, Jacques DL, Sibai BM. Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol 2001; 184(5): 979-83.
[http://dx.doi.org/10.1067/mob.2001.112905] [PMID: 11303208]
[27]
Laganà AS, Favilli A, Triolo O, Granese R, Gerli S. Early serum markers of pre-eclampsia: Are we stepping forward? J Matern Fetal Neonatal Med 2016; 29(18): 3019-23.
[http://dx.doi.org/10.3109/14767058.2015.1113522] [PMID: 26512423]
[28]
Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, et al. ESC guidelines on the management of cardiovascular diseases during pregnancy: the task force on the management of cardiovascular diseases during pregnancy of the european society of cardiology (ESC). Eur Heart J 2011; 32(24): 3147-97.
[http://dx.doi.org/10.1093/eurheartj/ehr218] [PMID: 21873418]
[29]
Silversides CK, Colman JM, Sermer M, Farine D, Siu SC. Early and intermediate-term outcomes of pregnancy with congenital aortic stenosis. Am J Cardiol 2003; 91(11): 1386-9.
[http://dx.doi.org/10.1016/S0002-9149(03)00340-0] [PMID: 12767444]
[30]
Oylumlu M, Aykent K, Soydinc HE, et al. Pulmonary balloon valvuloplasty during pregnancy. Case Rep Cardiol 2012; 2012: 353168.
[http://dx.doi.org/10.1155/2012/353168] [PMID: 24860677]
[31]
Drenthen W, Pieper PG, Roos-Hesselink JW, et al. Non-cardiac complications during pregnancy in women with isolated congenital pulmonary valvar stenosis. Heart 2006; 92(12): 1838-43.
[http://dx.doi.org/10.1136/hrt.2006.093849] [PMID: 16818485]
[32]
Hisatomi K, Isomura T, Kosuga K, et al. An evaluation of long-term results over 10 years after intracardiac repair of tetralogy of Fallot. Kurume Med J 1991; 38(3): 149-57.
[http://dx.doi.org/10.2739/kurumemedj.38.149] [PMID: 1779602]
[33]
Connolly HM, Warnes CA. Ebstein’s anomaly: outcome of pregnancy. J Am Coll Cardiol 1994; 23(5): 1194-8.
[http://dx.doi.org/10.1016/0735-1097(94)90610-6] [PMID: 8144788]
[34]
Elkayam U, Bitar F. Valvular heart disease and pregnancy: part II: prosthetic valves. J Am Coll Cardiol 2005; 46(3): 403-10.
[http://dx.doi.org/10.1016/j.jacc.2005.02.087] [PMID: 16053950]
[35]
Monteiro AV, Rebelo J, Patricio L, Campos A, Borges A, Ferreira RC. Ten years’ experience of pregnancy outcomes in women with cardiac valvulopathies: Are valve prostheses worst? J Heart Valve Dis 2015; 24(3): 368-75.
[PMID: 26901914]
[36]
van Hagen IM, Roos-Hesselink JW, Ruys TP, et al. Pregnancy in women with a mechanical heart valve: data of the european society of cardiology registry of pregnancy and cardiac disease (ROPAC). Circulation 2015; 132(2): 132-42.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.115.015242] [PMID: 26100109]
[37]
Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 2017; 38(36): 2739-91.
[http://dx.doi.org/10.1093/eurheartj/ehx391] [PMID: 28886619]
[38]
Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the management of patients with valvular heart disease: Executive Summary: A report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation 2021; 143(5): e35-71. [published correction appears in Circulation. 2021 Feb 2;143(5):e228]. [published correction appears in Circulation. 2021 Mar 9;143(10):e784].
[PMID: 33332149]
[39]
Eghbali M, Wang Y, Toro L, Stefani E. Heart hypertrophy during pregnancy: A better functioning heart? Trends Cardiovasc Med 2006; 16(8): 285-91.
[http://dx.doi.org/10.1016/j.tcm.2006.07.001] [PMID: 17055385]
[40]
Schaufelberger M. Cardiomyopathy and pregnancy. Heart 2019; 105(20): 1543-51.
[http://dx.doi.org/10.1136/heartjnl-2018-313476] [PMID: 31308064]
[41]
Saini H, Tabtabai S, Stone JR. Pathophysiology of cardiomyopathies. In: Willis MS, Homeister JW, Stone JR, Eds. cellular and molecular pathobiology of cardiovascular disease. San Diego: Academic Press 2014; pp. 101-19.
[http://dx.doi.org/10.1016/B978-0-12-405206-2.00006-5]
[42]
McNamara DM, Elkayam U, Alharethi R, et al. Clinical outcomes for peripartum cardiomyopathy in north america: results of the ipac study (investigations of pregnancy-associated cardiomyopathy). J Am Coll Cardiol 2015; 66(8): 905-14.
[http://dx.doi.org/10.1016/j.jacc.2015.06.1309] [PMID: 26293760]
[43]
McNamara DM, Starling RC, Cooper LT, et al. Clinical and demographic predictors of outcomes in recent onset dilated cardiomyopathy: results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 study. J Am Coll Cardiol 2011; 58(11): 1112-8.
[http://dx.doi.org/10.1016/j.jacc.2011.05.033] [PMID: 21884947]
[44]
Hilfiker-Kleiner D, Haghikia A, Berliner D, et al. Bromocriptine for the treatment of peripartum cardiomyopathy: A multicentre randomized study. Eur Heart J 2017; 38(35): 2671-9.
[http://dx.doi.org/10.1093/eurheartj/ehx355] [PMID: 28934837]
[45]
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J. 2018 ESC guidelines for the management of cardiovascular disease during pregnancy: the task force for the management of cardiovascular diseases during pregnancy of the european society of cardiology. Eur Heart J 2018; 34: 3165-241.
[http://dx.doi.org/10.1093/eurheartj/ehy340] [PMID: 30165544]
[46]
Baumgartner H, Bonhoeffer P, De Groot NM, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010; 31(23): 2915-57.
[http://dx.doi.org/10.1093/eurheartj/ehq249] [PMID: 20801927]
[47]
King TC. 7 - Cardiovascular Pathology.Elsevier’s Integrated Pathology. Philadelphia: Mosby 2007; pp. 169-95.
[http://dx.doi.org/10.1016/B978-0-323-04328-1.50013-9]
[48]
Bondagji NS. Ischaemic heart disease in pregnancy. J Saudi Heart Assoc 2012; 24(2): 89-97.
[http://dx.doi.org/10.1016/j.jsha.2011.12.002] [PMID: 23960678]
[49]
Koul AK, Hollander G, Moskovits N, Frankel R, Herrera L, Shani J. Coronary artery dissection during pregnancy and the postpartum period: two case reports and review of literature. Catheter Cardiovasc Interv 2001; 52(1): 88-94.
[http://dx.doi.org/10.1002/1522-726X(200101)52:1<88::AID-CCD1022>3.0.CO;2-P] [PMID: 11146532]
[50]
Kinney-Ham L, Nguyen HB, Steele R, Walters EL. Acute aortic dissection in third trimester pregnancy without risk factors. West J Emerg Med 2011; 12(4): 571-4.
[http://dx.doi.org/10.5811/westjem.2011.5.2257] [PMID: 22224164]
[51]
Goland S, Elkayam U. Pregnancy and Marfan syndrome. Ann Cardiothorac Surg 2017; 6(6): 642-53.
[http://dx.doi.org/10.21037/acs.2017.10.07] [PMID: 29270376]
[52]
Beighton P, De Paepe A, Steinmann B, Tsipouras P, Wenstrup RJ. Ehlers-Danlos syndromes: revised nosology, Villefranche, 1997. Am J Med Genet 1998; 77(1): 31-7.
[http://dx.doi.org/10.1002/(SICI)1096-8628(19980428)77:1<31::AID-AJMG8>3.0.CO;2-O] [PMID: 9557891]
[53]
Watson WD, Bhagra SK, Bhagra CJ. Pregnancy in heart transplant recipients-current perspectives. Transpl Res Risk Manag 2019; 11: 29-38.
[http://dx.doi.org/10.2147/TRRM.S188281]

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