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Chapter 4 - Challenging Cardiac Disorders in Pregnancy

Published online by Cambridge University Press:  26 January 2024

By
Hanna Hussey ,
Patrick Hussey  and
Marie-Louise Meng
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Grace Lim
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Grace Lim
Affiliation:
University of Pittsburgh
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Summary

Cardiovascular disease (>25%) is the leading cause of death among pregnant women in the United States. This chapter covers risk stratification, pathophysiology, and anesthetic management of women with specific cardiac diseases. In the last decade, advances in treatment and management of cardiac disease in the pregnant patient have led to improvements in survival of obstetric patients with known cardiac disease. Key to the improvements in care is the creation of Pregnancy Heart Teams, multidisciplinary teams with knowledge and experience caring for the obstetric patient with cardiovascular disease. Cardiovascular disease encompasses a heterogeneous group of lesions with differing hemodynamic goals, management and risks during pregnancy, delivery, and postpartum. The anesthesiologist is best able to care for these women by understanding the specific cardiovascular lesion, a woman’s current status, the obstetric and fetal considerations and the impact of anesthetic techniques.

Keywords

cardiovascular diseaserisk stratificationperipartum cardiomyopathyvalvular diseasepregnancy heart teamcongenital heart diseasecardiac assist devicesanticoagulationneuraxial anesthesia
Type
Chapter
Information
Obstetric Anesthesia and Uncommon Disorders , pp. 25 - 46
Publisher: Cambridge University Press
Print publication year: 2024

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