Echocardiography for the Pregnant Heart

Abstract

Purpose of review Pregnancy is associated with significant hemodynamic changes, making it a potentially high-risk period for women with underlying cardiovascular disease. Echocardiography remains the preferred modality for diagnosis and monitoring of pregnant women with cardiovascular disease as it is widely available and does not require radiation. This paper reviews the role of echocardiography along the continuum of pregnancy in at-risk patients, with a focus on key cardiac disease states in pregnancy. Recent findings In the preconception stage, risk stratification scores such as CARPREG II, ZAHARA and the modified WHO remain central to counseling and planning. As such, echocardiography serves an important role in assessing the severity of pre-existing structural disease. Among women with pre-existing cardiovascular disease who become pregnant-as well as those who develop cardiovascular symptoms during pregnancy-echocardiography is a key imaging tool for assessment of hemodynamic and structural changes and is recommended as the first-line imaging modality when appropriate by both the American College of Obstetricians and Gynecologists (ACOG) and the Food and Drug Administration (FDA). However, routine screening intervals during pregnancy for various cardiac lesions are not well defined, resulting in clinical heterogeneity in care. Summary Echocardiography is the imaging modality of choice for defining, risk stratifying, and monitoring cardiovascular changes throughout pregnancy. Once identified, at-risk patients should receive careful individual counseling and follow-up with a multidisciplinary team. Echocardiography serves as a widely available tool for serial monitoring of pregnant women with cardiovascular disease throughout pregnancy and the postpartum period.

Early Assessment of Cardiac Function by Echocardiography in Patients with Gestational Diabetes Mellitus

“…The goal of this study was to compare and contrast the cardiac function of pregnant women who had or did not have diabetes. [ 12 ]. Our working hypothesis was gestational diabetes can affect the cardiac function and structure of pregnant women.…”

Infographic. Head to toe considerations for the postpartum endurance athlete

“…During pregnancy, cardiovascular changes include increased resting cardiac output conferred by increased heart rate and stroke volume and lower systemic vascular resistance 7. The increased cardiac output in postpartum athletes may persist up to 1 year 7.…”

“…During pregnancy, cardiovascular changes include increased resting cardiac output conferred by increased heart rate and stroke volume and lower systemic vascular resistance 7. The increased cardiac output in postpartum athletes may persist up to 1 year 7. While the performance-enhancing potential for these persistent physiological changes in the postpartum period is debated, it is notable that changes are similar to results of endurance exercise training.…”

Inestabilidad hemodinámica en obstetricia

“…En la embarazada normal se producen cambios a nivel cardiovascular desde el inicio del embarazo, estos cambios anatómicos y hemodinámicos pueden ser visualizados por la ecocardiografía (Tabla 2) [17].…”