Heart disease &pregnancy

Dr Movahedi

Clinical indicators of

Hear disease & pregnancy

Symptoms: Progressive dyspnea or orthopnea Nocturnal cough Hemoptysis Syncope Chest pain

Sings :Cyanosis Cubbing of fingers Persistent neck vein distension Systolic murmur > or = 3/6 Diastolic murmur Cardiomegaly

.…Sings :

Persistent arrhythmia Persistent split second sound Criteria for pulmonary hypertension

Clinical classification of heart disease

Class I uncompromisedClass II slight limitation Ph.AClass III marked limitation Ph.AClass IV severely compromised

Predictors of cardiac complicators

* Prior heart failure , TIA , arrhythmia – stroke *Class III or IV or cianosis *left-side obstruction mitral value area < 2 Cm2

Aortic value area < 1.5 Cm2

Peak left ventilator gradient > 30 mmHg * EF < 40 %

Peripartum cardiomyopathy 1- cardiac failure in the last month or within 5 months 2- absence of cause for failure .3- absences of prior hard disease .4- Left ventricular systolic dysfunction .