Cardiological Problems in Younger Women: Including Those of Pregnancy and the Puerperium

Abstract

Women are endowed with certain advantages. They face fewer hazards than the male, whom they tend to outlive. In infancy and childhood mortality among boys is greater than in girls, and in middle life ischaemic heart disease takes a much greater toll among men. The Registrar-General's figures tell us, for instance, that in the five-year period 1953-7 the mortality from coronary artery disease in the age-group 55-59 years was four and a half times higher for men than for women. Age and sex may thus influence the development and progression of vascular disease. Life expectancy for the female now exceeds that of the male by a greater number of years than ever before. Hence a closer study of the "feminine" response to long-term cardiovascular damage ought to increase our understanding of the basic processes involved.

Mortalidade materna por cardiopatia

“…A assistência pré-natal, iniciada em fase precoce da gestação e realizada conjuntamente pelo obstetra e pelo cardiologista, desempenha um papel de fundamental importância no sucesso da condução da gestante cardiopata 2,23,67,72 . Pela análise estatística (Tabela 3), constatou-se que a não realização de pré-natal esteve associada a maior risco de óbito materno.…”

“…Por outro lado, aquelas incluidas nas classes III e IV pertencem ao grupo desfavorável, sendo a gravidez desaconselhada, pelo elevado obituário materno 23,26,74 . Na presente casuística verificou-se, entretanto, que 91,7% (11/12) das mortes maternas ocorreram em pacientes que pertenciam ao grupo favorável no período pré-gestacional, sendo que 83,3% continuavam no referido grupo ao término do primeiro trimestre.…”

“…No que concerne às complicações ou causas imediatas de morte materna por cardiopatia, a insuficiência cardíaca congestiva, associada ao edema agudo de pulmão, é a grande causa, ocorrente em mais de 50,0% dos casos 23,54,67 . Em segundo lugar, aparece o tromboembolismo, com incidência variando de 9,0 a 16,0%, seguido da endocardite bacteriana.…”

Heart Disease of Pregnancy and Puerperium

“…Giixhkist [9] identified two groups under the title of cardiomyo pathy of pregnancy and the puerperium. One group presented with congestive cardiac failure and in the other, angina and tachycar dia were the dominant features.…”

Cardiomyopathy and pregnancy.

“…She still has a loud third heart sound with slight cardiac enlargement on chest x-ray film, and it is hoped to investigate her more fully. Gilchrist (1963) has attempted to classify pregnancy cardiomyopathies into two groups. One presents with congestive cardiac failure and the other is characterized by angina and tachycardia, congestive heart failure being rare.…”