Use of Medication for Cardiovascular Disease During Pregnancy

Halpern, Dan; Weinberg, Catherine R.; Pinnelas, Rebecca; Mehta‐Lee, Shilpi S.; Economy, Katherine E.; Valente, Anne Marie

doi:10.1016/j.jacc.2018.10.075

Cited by 201 publications

(145 citation statements)

References 150 publications

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“…The use of inotropic drugs in patients with CS is often limited due to the development of tachycardia, hypotension, and arrhythmias . In addition, these drugs should be used with caution during pregnancy as fetal safety is not known due to limited information …”

Section: Discussionmentioning

confidence: 99%

“…21,22 In addition, these drugs should be used with caution during pregnancy as fetal safety is not known due to limited information. 23 The recommendations of the PPCM working group for the management of severe PPCM also include considerations for the use of bromocriptine. The use of bromocriptine in addition to standard heart failure therapy in the attempt to block the detrimental effect of cleaved prolactin has been shown to increase the rate of LV recovery and reduce mortality in two randomized, open-label trials conducted in Africa.…”

Section: Discussionmentioning

confidence: 99%

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Use of Impella heart pump for management of women with peripartum cardiogenic shock

Elkayam

Schäfer

Chieffo

et al. 2019

Clinical Cardiology

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Background Percutaneous mechanical circulatory support (MCS), such as the Impella heart pump is a valuable option for cardiogenic shock (CS), although the use of Impella in CS due to peripartum cardiomyopathy (PPCM) is limited. Objective To assess outcomes in women with PPCM supported with an Impella device from the global catheter‐based ventricular assist device (cVAD) Registry. Methods and Results A total of 15 women with PPCM supported with Impella devices between November 2008 and October 2015 were included. Of the 15 women, five were treated at Hannover medical school and have been reported previously, the rest were managed at various US hospitals. The mean age was 30.0 ± 7.34 years, eight women were Caucasian, and seven were African‐American. The occurrence of PPCM was post‐delivery in eight (53.3%), at delivery in one (6.7%), and during gestation in four women (26.7%). At admission, all women had severe heart failure with a mean ejection fraction of 14.7 ± 6% and 13 women (86.7%) presented with CS. Prior to Impella, 100% were mechanically ventilated, 79% received inotropes/vasopressors, 20% supported with IABP, and 27% received veno‐arterial extracorporeal membrane oxygenation (VA ECMO) during Impella support. Two women (13.3%) died, and 13 (87.7%) survived to discharge. Eight women (53.3%) had a recovery of native heart function and six (40%) were bridged to durable left ventricular assist device (LVAD). Conclusion MCS with Impella devices can be successfully used as a bridge to early improvement, heart recovery, or successful implantation of durable LVAD in women with PPCM complicated by severe LV dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of Impella heart pump for management of women with peripartum cardiogenic shock

Elkayam

Schäfer

Chieffo

et al. 2019

Clinical Cardiology

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“…The risks and benefits to both the mother and fetus must be considered when determining the use and safety of medications during pregnancy. 7,8,10 Exposure to medications during the first 2 weeks after conception can result in fetal demise, whereas teratogenicity usually occurs between 4 and 12 weeks of gestation. An extensive review of the safety of medications for cardiovascular disease during pregnancy has been published previously.…”

Section: Medicationsmentioning

confidence: 99%

“…An extensive review of the safety of medications for cardiovascular disease during pregnancy has been published previously. 10 Beta-blockers are the most widely used cardiac medication during provider is essential because all pose an increased risk of gestational complications. 7,8,10 Warfarin crosses the placenta and is associated with embryopathy, miscarriage, and stillbirth, with increasing complications at doses >5 mg.…”

Section: Medicationsmentioning

confidence: 99%

Pregnancy in Women with Congenital Heart Disease: A Guide for the General Cardiologist

Weinberg

Ahmad²,

Li³

et al. 2020

US Cardiology Review

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Remarkable advances in the care and survival of congenital heart disease (CHD) patients have led to increasing numbers of young women with CHD who carry a pregnancy with significant risk. The profound hemodynamic changes that naturally occur during gestation may unmask CHD or exacerbate an existing condition and place both the woman and fetus in jeopardy. The caring cardiologist should be familiar with the specific lesion and anticipate complications. Pregestational counseling and a multidisciplinary team approach during pregnancy are key for a successful pregnancy and favorable outcomes. In this review we discuss the evaluation of the expecting CHD patient and focus on the commonly encountered lesions.

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“…Во время 2 и 3 триместров у беременных женщин без наличия WPW-синдрома для предотвращения пароксизмов СВТ следует использовать селективные бета-1-адреноблокаторы или верапамил, с наличием WPW-синдрома -флекаинид или пропафенон (при отсутствии ИБС и структурной патологии сердца) [1]. Однако следует помнить о том, что все бета-блокаторы могут вызывать брадикардию и гипогликемию плода, а также описаны ассоциированные с приемом бета-блокаторов случаи врожденного поликистоза почек [39][40]. При плохой переносимости СВТ или рефрактерности к консервативной терапии, начиная со 2 триместра беременности, может быть выполнена нефлюороскопическая РЧА источника аритмии (при наличии соответствующей системы картирования) [41].…”

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2019 European Society of Cardiology Guidelines for the Management of Patients With Supraventricular Tachycardia: What’s New?

Kalatsei¹,

Snezhitskiy²

2020

Journal GSMU

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Гродненский государственный медицинский университет, Гродно, Беларусь В данной статье представлен обзор клинических рекомендаций Европейского общества кардиологов по лечению пациентов с суправентрикулярными тахикардиями, разработанных совместно с Европейской ассоциацией специалистов по детской кардиологии и врожденным порокам сердца, представленных во время Европейского конгресса кардиологов в Париже 31 августа 2019 г. Новые рекомендации затрагивают вопросы диагностики, неотложного купирования и длительной терапии всех суправентрикулярных тахикардий, за исключением фибрилляции предсердий, и включают главы, посвященные терапии суправентрикулярных нарушений ритма у пациентов с врожденными пороками сердца, тахи-индуцированной кардиомиопатией, у беременных женщин. Особое внимание уделяется применению радиочастотной аблации как наиболее современной, эффективной и динамично развивающейся методике эрадикации аритмий. Ключевые слова: суправентрикулярные тахикардии, антиаритмические препараты, радиочастотная аблация, тахи-индуцированная кардиомиопатия.

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Use of Medication for Cardiovascular Disease During Pregnancy

Cited by 201 publications

References 150 publications

Use of Impella heart pump for management of women with peripartum cardiogenic shock

Use of Impella heart pump for management of women with peripartum cardiogenic shock

Pregnancy in Women with Congenital Heart Disease: A Guide for the General Cardiologist

2019 European Society of Cardiology Guidelines for the Management of Patients With Supraventricular Tachycardia: What’s New?

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