Cardiac Problems in Pregnancy

Cardiac Problems in Pregnancy offers clinicians the most detailed and comprehensive guide to diagnosing and managing pregnancy-associated cardiovascular diseases currently available. Covering a wide spectrum of congenital and acquired cardiovascular conditions, its extensive contents examine diseases of the heart with an expert awareness of the implications of pregnancy and the attendant physiological changes it brings. Such guidance is vitally required in an age in which congenital and acquired heart diseases are the leading causes of non-obstetrical maternal morbidity and mortality.

Featuring 36 new or extensively revised chapters, this fourth edition of the book complements coverage of the latest research and clinical advances with a complete and up-to-date bibliography of literature on pregnancy in women with cardiovascular conditions. It also serves as a practical, step-by-step companion for those caring for heart disease patients during pregnancy, labor, and the post-partum period.
Contents include:

• Coverage of all elements of maternal cardiology
• Newly written chapters featuring fresh research and data
• Guidance on performing risk assessments and interventions both prior to and during gestation
• Explanations of a range of diagnostic and therapeutic approaches to cardiovascular disease in pregnant patients

Drawing on expertise from across the fields of cardiovascular medicine, obstetrics, anesthesiology, cardiac surgery, pharmacology, and clinical science, Cardiac Problems in Pregnancy is designed to give invaluable support to all medical professionals involved in maximizing the safety and success of cardiologically complex pregnancies.

Cardiac Problems in Pregnancy ist ein einzigartig ausführliches und umfassendes Fachbuch für die Diagnose und das Management von in der Schwangerschaft auftretenden kardiovaskulären Erkrankungen. Es beschreibt eine Vielzahl von angeborenen und erworbenen kardiovaskulären Krankheiten, untersucht Erkrankungen des Herzens vor dem Hintergrund der Auswirkungen auf die Schwangerschaft und die zu erwartenden physiologischen Veränderungen. Diese Hilfestellung ist dringend erforderlich, da angeborene und erworbene Herzerkrankungen die Hauptursachen für die Morbidität und Mortalität von Müttern sind.
Diese 4. Auflage mit 36 neuen oder umfassend überarbeiteten Kapiteln enthält die neuesten Erkenntnisse aus Forschung und Klinik und eine aktualisierte Bibliographie von Publikationen zum Thema Schwangerschaft bei Frauen mit kardiovaskulären Erkrankungen. Das Fachbuch ist auch eine praktische Schritt-für-Schritt-Anleitung für Pflegepersonal, das Patientinnen mit Herzerkrankungen während der Schwangerschaft, unter der Geburt und im Wochenbett betreuen.
Inhalte:
- Alles Wissenswerte zu kardiologischen Erkrankungen bei Schwangeren.
- Überarbeitete Kapitel mit aktuellen Forschungserkenntnissen und Daten.
- Handreichungen zur Durchführung von Risikobewertungen und Eingriffen vor und während einer Schwangerschaft.
- Erläuterung von diagnostischen und therapeutischen Ansätzen bei kardiovaskulären Erkrankungen in der Schwangerschaft.

About the Editor ix

List of Contributors x

Preface xiii

Acknowledgments xiv

Part I Physiologic Changes During Normal Pregnancy and the Puerperium 1

1 Hemodynamic and Cardiac Function 3
Ofer Havakuk and Uri Elkayam

Part II Cardiac Evaluation of the Pregnant Woman 17

2 Cardiovascular Evaluation During Pregnancy 19
Uri Elkayam

3 Cardiovascular Imaging in the Pregnant Patient 32
Patrick Colletti and Uri Elkayam

Part III Cardiac Disorders and Pregnancy 41

4 Risk Assessment Prior and During Pregnancy 43
Samuel C. Siu and Candice K. Silversides

5 Congenital Heart Disease and Pregnancy 60
Candice K. Silversides, Jack M. Colman, and Samuel C. Siu

6 Native Valvular Heart Disease and Pregnancy 75
Uri Elkayam

7 Pregnancy in the Patient with Prosthetic Heart Valves 90
Uri Elkayam

8 Myocarditis and Pregnancy 107
Avraham Shotan and Andrei Keren

9 Pericardial Disorders and Pregnancy 116
Marla A. Mendelson

10 Peripartum Cardiomyopathy 128
Sorel Goland and Uri Elkayam

11 Dilated Cardiomyopathy and Pregnancy 155
Kathleen Stergiopoulos and Fabio V. Lima

12 Hypertrophic Cardiomyopathy and Pregnancy 167
Iris M. van Hagen, Uri Elkayam, Sorel Goland, and Jolien W. Roos-Hesselink

13 Left Ventricular Noncompaction 181
Radha J. Sarma

14 Acute Myocardial Infarction and Pregnancy 201
Uri Elkayam and Ofer Havakuk

15 Cardiac Arrhythmias and Pregnancy 220
Danna Spears and Uri Elkayam

16 Pulmonary Arterial Hypertension and Pregnancy 252
Dianne Zwicke, Sara Paulus, and Vinay Thohan

17 Infective Endocarditis 261
Ramin Ebrahimi, Michael Shenoda, Sheila Sahni, and David Fisk

Part IV Vascular Disease in Pregnancy 275

18 Vascular Dissections and Aneurysms During Pregnancy 277
Afshan B. Hameed

19 Marfan Syndrome and Pregnancy 285
Sorel Goland and Uri Elkayam

20 Non-Marfan Aortopathies and the Pregnant Patient 305
John Bois and Heidi Connolly

21 Takayasu’s Arteritis and Pregnancy 319
Abha Khandelwal

22 Thromboembolic Disease in Pregnancy 326
Courtney C. Bilodeau and Karen Rosene-Montella

23 Amniotic Fluid Embolism and Pregnancy 334
Irene A. Stafford, Steven L. Clark, and Gary A. Dildy

24 Hypertension During Pregnancy 339
Chonyang L. Albert and Leslie Cho

25 Syncope in Pregnancy 349
Paul S. Gibson

Part V Cardiac Surgery and Catheter Based Interventions During Pregnancy 359

26 Cardiac Surgery During Pregnancy 361
Anita Nguyen and Hartzell V. Schaff

27 Catheter-Based Interventions in Women with Heart Disease During Pregnancy 370
Anil Mehra, Gassan Muadi, Pavan Reddy, and Uri Elkayam

28 Analgesia and Anesthesia During Pregnancy, Labor, and Delivery 389
Katherine W. Arendt

29 Cardiopulmonary Resuscitation of Pregnant Women 397
Joan Briller

30 Pregnancy After Cardiac Transplantation 419
Serban Constantinescu, Dawn P. Armenti, Lisa A. Coscia, Lynn R. Punnoose, John M. Davison, and Michael J. Moritz

Part VI Cardiovascular Drug Therapy During Pregnancy 433

31 Pharmacokinetics of Drugs in Pregnancy and Lactation 435
Irving Steinberg

32 Cardiovascular Drugs in Pregnancy and Lactation 456
Petronella G. Pieper, Uri Elkayam, Joy Eskandar, and Titia P.E. Ruys

33 Tocolytic Therapy in the Cardiac Patient 491
Joseph G. Ouzounian

34 Fertility Control in the Cardiac Patient 497
Joan Briller, Mark R. Johnson, and Jolien W. Roos-Hesselink

Part VII Labor and Delivery 513

35 Management of Labor and Delivery in a Cardiac Patient 515
Rohan D’Souza and Mathew Sermer

36 Cardiac Effects of Drugs Used for Induction of Labor and Prevention and Treatment of Postpartum Hemorrhage 530
Mark R. Johnson

Index 537

Uri Elkayam, MD, Professor of Medicine, Obstetrics, and Gynecology and Director of Maternal Cardiology, University of Southern California, Los Angeles, CA, USA

The essential clinical reference guide to maternal cardiology

Cardiac Problems in Pregnancy offers clinicians the most detailed and comprehensive guide to diagnosing and managing pregnancy-associated cardiovascular diseases currently available. Covering a wide spectrum of congenital and acquired cardiovascular conditions, its extensive contents examine diseases of the heart with an expert awareness of the implications of pregnancy and the attendant physiological changes it brings. Such guidance is vitally required in an age in which congenital and acquired heart diseases are the leading causes of non-obstetrical maternal morbidity and mortality.

Featuring 36 new or extensively revised chapters, this fourth edition of the book complements coverage of the latest research and clinical advances with a complete and up-to-date bibliography of literature on pregnancy in women with cardiovascular conditions. It also serves as a practical, step-by-step companion for those caring for heart disease patients during pregnancy, labor, and the post-partum period. Contents include:

• Coverage of all elements of maternal cardiology
• Newly written chapters featuring fresh research and data
• Guidance on performing risk assessments and interventions both prior to and during gestation
• Explanations of a range of diagnostic and therapeutic approaches to cardiovascular disease in pregnant patients

Drawing on expertise from across the fields of cardiovascular medicine, obstetrics, anesthesiology, cardiac surgery, pharmacology, and clinical science, Cardiac Problems in Pregnancy is designed to give invaluable support to all medical professionals involved in maximizing the safety and success of cardiologically complex pregnancies.