Heart diseases in pregnancy | Obstetrics | Med Vids made simple

Summary

This video discusses heart diseases in pregnancy, focusing on congenital and rheumatic heart diseases. It explains the common symptoms, such as shortness of breath and chest pain, and describes how these conditions impact the cardiovascular system during pregnancy. The video also touches on classification systems like the NYHA classification for disease severity. For rheumatic heart disease, it discusses management, including surgery and lifestyle changes, while also addressing congenital heart defects like ASD, VSD, and Tetralogy of Fallot. It concludes by comparing the prevalence and management of these conditions in developed versus developing countries.

Takeaways

• 😀 Most common heart diseases in pregnancy include congenital heart diseases and rheumatic heart disease.
• 😀 Symptoms of heart disease in pregnancy include shortness of breath (dyspnea), palpitations, chest pain, cyanosis, clubbing, heart murmurs, and arrhythmias.
• 😀 Physiological changes during pregnancy involve increased cardiac output, stroke volume, and heart rate, while blood pressure decreases.
• 😀 The New York Heart Association (NYHA) classification categorizes heart disease severity from Class 1 (no limitations) to Class 4 (severe limitations and breathlessness at rest).
• 😀 Rheumatic heart disease often leads to mitral stenosis, causing pulmonary hypertension and pulmonary edema due to blood accumulation in the left atrium.
• 😀 Balloon valvuloplasty is a preferred treatment for narrowing of the mitral valve during pregnancy to improve blood flow.
• 😀 Lifestyle changes such as limiting physical activity and reducing salt intake are essential for managing heart disease in pregnancy.
• 😀 Congenital heart diseases like atrial septal defects (ASD), ventricular septal defects (VSD), and patent ductus arteriosus (PDA) are less risky during pregnancy, though treatment before pregnancy is preferred.
• 😀 Tetralogy of Fallot is a high-risk congenital heart disease that can cause complications such as threatened abortion if untreated prior to pregnancy.
• 😀 In developed countries, the incidence of rheumatic heart disease is decreasing due to proper antibiotic treatment, while congenital heart diseases can be managed more effectively with advanced surgeries.
• 😀 In developing and underdeveloped countries, rheumatic heart disease remains common, and congenital heart disease treatment is often inadequate due to limited surgical access.

Q & A

What are the two main types of heart diseases that complicate pregnancy?

The two main types of heart diseases that complicate pregnancy are congenital heart diseases, which are present from birth, and rheumatic heart disease, which develops from improperly treated beta-hemolytic streptococcal infections.

What are the common symptoms of heart disease during pregnancy?

Common symptoms of heart disease during pregnancy include shortness of breath (dyspnea), palpitations, chest pain, and physical signs such as cyanosis, clubbing, thrills, murmurs, and arrhythmias.

What physiological changes occur in the cardiovascular system during pregnancy?

During pregnancy, physiological changes in the cardiovascular system include an increase in cardiac output, stroke volume, and heart rate, while peripheral vascular resistance and blood pressure decrease.

What does the NYHA classification represent, and how does it classify heart disease severity?

The NYHA (New York Heart Association) classification categorizes the severity of heart disease based on physical activity limitations. It ranges from Class 1 (no limitations) to Class 4 (severe limitations, with symptoms even at rest).

How is rheumatic heart disease typically managed in pregnant women?

Management of rheumatic heart disease in pregnant women often involves surgery (preferably before pregnancy) or balloon valvuloplasty during pregnancy. Additionally, lifestyle changes such as limited physical activity, salt restriction, and the use of diuretics are advised.

What are the consequences of mitral stenosis in patients with rheumatic heart disease?

Mitral stenosis, common in rheumatic heart disease, leads to narrowing of the mitral valve, causing blood accumulation in the left atrium. This increases pulmonary pressure, which can result in pulmonary hypertension, pulmonary edema, and atrial fibrillation.

What is the role of balloon valvuloplasty in treating rheumatic heart disease during pregnancy?

Balloon valvuloplasty is a procedure used to dilate the narrowed mitral valve in pregnant women with rheumatic heart disease. It helps prevent blood accumulation in the left atrium and improves the patency of the mitral valve.

What is the primary risk associated with tetralogy of Fallot during pregnancy?

Tetralogy of Fallot poses a high risk during pregnancy, including the possibility of threatened abortion and difficulty in fetal survival. It involves right-to-left shunting of blood, which can lead to severe complications if not corrected before pregnancy.

Why is it important to treat congenital heart defects before pregnancy?

Treating congenital heart defects before pregnancy reduces the risks associated with pregnancy complications, such as difficulty in managing increased blood flow and pressure. This ensures better health outcomes for both the mother and the fetus.

How do the incidence rates of rheumatic heart disease and congenital heart defects differ between developed and developing countries?

In developed countries, the incidence of rheumatic heart disease has decreased due to improved use of antibiotics and better cardiac surgeries. However, in developing and underdeveloped countries, rheumatic heart disease remains common, and congenital heart defects may not be adequately treated due to limited access to surgical care.