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Cardiomyopathy pregnancy

Giuseppe Limongelli, Marta Rubino, Augusto Esposito, Mariagiovanna Russo, Giuseppe Pacileo
PURPOSE OF REVIEW: To discuss the risk preexisting or new onset cardiomyopathy/heart failure (CMP/heart failure) in pregnant woman, and recent insights regarding their management and therapy. RECENT FINDINGS: Recent data from the European Registry on Pregnancy and Heart disease of the European Society of Cardiology (ROPAC) suggest that, after an adequate prepregnancy evaluation in specialized centres, the vast majority of pregnancies are safe for both mother and foetus...
October 6, 2018: Current Opinion in Obstetrics & Gynecology
Z L Bao, J Zhang
Objective: To summarize and analyze the methods of termination of pregnancy in the first and second trimester of pregnancy with severe cardiovascular disease. Methods: A retrospective analysis of 27 cases of termination of pregnancy in the first and second trimester of pregnancy in Beijing Anzhen Hospital from January 1, 2016 to December 30, 2017. All of these pregnant women were pregnancy complicated with severe cardiovascular disease in grade Ⅴ pregnancy risk. Results: (1) The age of 27 pregnant women was 22-40 years, gestational age was 6-27 weeks; cardiac function grade before induced labor was: 5 cases of grade Ⅱ, 15 cases of grade Ⅲ, 7 cases of grade Ⅳ...
September 25, 2018: Zhonghua Fu Chan Ke za Zhi
Sivan Reut Shiloh, Eyal Sheiner, Tamar Wainstock, Asnat Walfisch, Idit Segal, Daniella Landau, Avi Harlev
OBJECTIVE: To determine the risk of long-term cardiovascular disease (CVD) among children born following in vitro fertilization (IVF) and compared with spontaneous pregnancies. STUDY DESIGN: A population-based cohort study including all singleton deliveries occurring between 1991and 2014 at a tertiary medical center was performed. Hospitalizations up to the age of 18 years involving CVD were evaluated in children delivered following IVF, ovulation induction, and spontaneous pregnancies...
October 2, 2018: Journal of Pediatrics
Takeshi Mikami, Hitoshi Kamiunten
Peripartum cardiomyopathy (PPCM) is an idiopathic left ventricular dysfunction in women who are in late pregnancy or the postpartum period. PPCM is a rare but sometimes fatal disease, and mechanical circulatory support is required if heart failure is refractory to conventional therapy. A 28-year-old woman in late pregnancy was admitted to our hospital due to congestive heart failure with cardiogenic shock. Her heart rate was 200 beats per minute (sinus tachycardia), and left ventricular ejection fraction (LVEF) was 10%...
June 2018: Journal of Cardiology Cases
Armaan Shaikh, Tanvir Bajwa, Michelle Bush, A Jamil Tajik
Hypertrophic cardiomyopathy is a clinically heterogeneous disease with common findings of ventricular hypertrophy, left ventricular outflow tract (LVOT) obstruction, mitral regurgitation, and diastolic dysfunction. Sometimes, the condition can lead to catastrophic cardiac events. Pregnancy can pose a larger challenge, due to medication restrictions associated with pregnancy. We report a case of a 43-year-old pregnant woman presenting with symptomatic hypertrophic obstructive cardiomyopathy (HOCM). As her pregnancy progressed, her HOCM worsened both symptomatically and by objective echocardiographic data...
May 2018: Journal of Cardiology Cases
Abigail Khan, Emmanuelle Paré, Shimoli Shah
PURPOSE OF REVIEW: This review summarizes the pathophysiology, diagnosis, and treatment of peripartum cardiomyopathy (PPCM), with a focus on recent discoveries of clinical relevance. RECENT FINDINGS: An increase in oxidative stress and anti-angiogenic activity play key roles in the pathophysiology of peripartum cardiomyopathy. Therapies that target this dysregulation may have a future role in treatment. Suppression of prolactin release using bromocriptine, a dopamine-receptor antagonist, has been associated with more favorable outcomes in small studies but more research is needed...
September 29, 2018: Current Treatment Options in Cardiovascular Medicine
Mukund Das, Anil Rathi, Ashwad Afzal, Kumudha Ramasubbu
Peripartum cardiomyopathy is a potentially life-threatening cause of heart failure (HF) that affects women toward the end of pregnancy or in months after delivery. Treatment is similar to the treatment for HF with reduced ejection fraction (EF). Most women make full myocardial function recovery within 6 months on conventional HF therapy. In rare instances, catastrophic presentations may occur with hemodynamic instability requiring the use of mechanical support. Because of the small patient population, limited information is available regarding the recovery of myocardial function in women who received mechanical support...
September 2018: Journal of Extra-corporeal Technology
Matthew Cauldwell, Philip Steer, Monique Sterrenburg, Suzanne Wallace, Gemma Malin, Gemma Ulivi, Thomas Everett, Adam Daniel Jakes, Catherine E G Head, Aarthi R Mohan, Sophie Haynes, Margaret Simpson, Janet Brennand, Mark R Johnson
OBJECTIVE: To assess median and percentile birthweight distribution in women with various groups of heart disease relative to a contemporaneous comparison group. METHODS: Data on birth weight and gestational age were collected from 1321 pregnancies ≥24 weeks' gestation in 1053 women with heart disease from seven UK maternity units. Women were assigned to one of 16 groups according to their cardiac lesion. In units where it was possible, data on two births, one delivering before and one after index cases, were collected, giving 2307 comparators...
September 21, 2018: Heart: Official Journal of the British Cardiac Society
Esa M Davis, Gregory Ewald, Michael M Givertz, Navin Rajagopalan, Leslie T Cooper, Joan Briller, G Michael Felker, Biykem Bozkurt, Mark H Drazner, Karen Hanley-Yanez, Indrani Halder, Charles F McTiernan, Dennis M McNamara
OBJECTIVE:  To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). STUDY DESIGN:  This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity...
September 5, 2018: American Journal of Perinatology
Reza Masoomi, Zubair Shah, Zoltan Arany, Kamal Gupta
OBJECTIVE: Peripartum cardiomyopathy (PPCM) can present during pregnancy and up to months post-delivery. Most large-scale epidemiologic studies have reported on cases occurring during pregnancy or the first few days postpartum (termPPCM). Limited information is available on PPCM in the later postpartum period (latePPCM). We studied the incidence, predictors, and hospital outcome of peripartum cardiomyopathy (PPCM) in the prepartum and immediate post delivery period versus up to 3 months post-delivery...
July 2018: Pregnancy Hypertension
Louise Marie Kofod, Finn Lauszus
Sinus tachycardia may have a definite aetiology, but in the remaining cases inappropriate sinus tachycardia (IST) may be considered. IST is primarily treated in order to improve symptoms. During pregnancy, tachycardia-induced cardiomyopathy is rare; however, it needs urgent attention and treatment due to the risk of fast progression. In Denmark, performing an electrocardiogram is recommended in any pregnant woman, who has palpitations or a persisting heart rate > 100 beats per minute.
August 20, 2018: Ugeskrift for Laeger
Vera Regitz-Zagrosek
Biological sex (being female or male) significantly influences the course of disease. This simple fact must be considered in all cardiovascular diagnosis and therapy. However, major gaps in knowledge about and awareness of cardiovascular disease in women still impede the implementation of sex-specific strategies. Among the gaps are a lack of understanding of the pathophysiology of women-biased coronary artery disease syndromes (spasms, dissections, Takotsubo syndrome), sex differences in cardiomyopathies and heart failure, a higher prevalence of cardiomyopathies with sarcomeric mutations in men, a higher prevalence of heart failure with preserved ejection fraction in women, and sex-specific disease mechanisms, as well as sex differences in sudden cardiac arrest and long QT syndrome...
September 2018: Korean Circulation Journal
Kathleen Stergiopoulos, Fabio V Lima
Peripartum cardiomyopathy (PPCM) is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period. While the disease is relatively uncommon, its incidence is rising. It is a form of idiopathic dilated cardiomyopathy, defined as pregnancy-related left ventricular dysfunction, diagnosed either towards the end of pregnancy or in the months following delivery, in women without any other identifiable cause. The clinical presentation, diagnostic assessment and treatment usually mirror that of other forms of cardiomyopathy...
August 1, 2018: Trends in Cardiovascular Medicine
Emily Lau, Doreen DeFaria Yeh
Cardiovascular disease contributes to approximately one third of all maternal mortality and remains a significant source of peri‑ and postpartum morbidity. As more women at risk for and with cardiovascular disease are desiring pregnancy, it is imperative that general cardiologists and obstetricians participate collaboratively in preconception counseling and are more facile with management of these lesions during peri‑ and postpartum periods. This review aims to address this growing need and highlights the management strategies for some of the major high risk cardiac conditions encountered during pregnancy including anticoagulation, cardiomyopathies as well as severe mitral and aortic stenosis; aortopathy, pulmonary hypertension, and severe congenital heart lesions will not be addressed...
July 22, 2018: Trends in Cardiovascular Medicine
Karen Sliwa, Feriel Azibani, Johann Baard, Ayesha Osman, Liesl Zühlke, Anthony Lachmann, Elena Libhaber, Ashley Chin, Mpiko Ntsekhe, Priya Soma-Pillay, Mark R Johnson, Jolien Roos-Hesselink, John Anthony
BACKGROUND: Late maternal mortality (up-to 1-year postpartum) is poorly reported globally and is commonly due to cardiovascular disease (CVD). We investigated targeted interventions aiming at reducing peripartum heart failure admission and late maternal death. METHODS AND RESULTS: Prospective single-centre study of 269 peripartum women presenting with CVD in pregnancy, or within 6-months postpartum. Both cardiac disease maternity (CDM) Group-I and Group-II were treated by a dedicated cardiac-obstetric team...
December 1, 2018: International Journal of Cardiology
Tomona Omotobara-Yabe, Shuji Kuga, Masahiro Takeguchi, Kenji Ihara
Breast feeding is known to be a major cause of vitamin D deficiency in infants because the content of vitamin D in breast milk is significantly lower than that in formula. We report a case of a 1-mo-old boy who developed hypocalcemic seizures and dilated cardiomyopathy caused by vitamin D deficiency despite being fed a sufficient amount of regular formula. The cause of vitamin D deficiency in this case was maternal vitamin deficiency due to severe hyperemesis and insufficient sunlight exposure, induced mainly by the malabsorption of fat-soluble vitamins caused by maternal cholestasis...
2018: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
Wei-Wei Wang, Yu Wang
Peripartum cardiomyopathy (PPCM) is life-threatening and its diagnosis is a challenge. We highlight the clinical characteristics and bio-markers of PPCM and the proper differential diagnosis of peripartum dyspnea to aim to make an early diagnosis available.We analyzed 262 peripartum patients with dyspnea, and summed up the final diagnosis. The clinical data of the control group and the PPCM group as well as before and after the treatment of the PPCM group were compared.In total, 147 (56%) of the perinatal patients were physiologic dyspnea of pregnancy; only 11 (4%) patients met the PPCM diagnostic criteria...
August 2018: Medicine (Baltimore)
Chrisandra L Shufelt, Christine Pacheco, Marysia S Tweet, Virginia M Miller
Sex differences in cardiovascular diseases can be classified as those which are specific to one sex and those that differ in incidence, prevalence, etiology, symptomatology, response to treatment, morbidity, and mortality in one sex compared to the other. All sex differences in cardiovascular conditions have their basis in the combined expression of genetic and hormonal differences between women and men. This chapter addresses how understanding basic mechanisms of hormone responses, imaging diagnostics, and integration of genomics and proteomics has advanced diagnosis and improved outcomes for cardiovascular conditions, apart from those related to pregnancy that are more prevalent in women...
2018: Advances in Experimental Medicine and Biology
Feriel Azibani, Karen Sliwa
PURPOSE OF REVIEW: Peripartum cardiomyopathy (PPCM) is an idiopathic disorder defined as heart failure occurring in women during the last month of pregnancy and up to 5 months postpartum. In this review, we outline recent reports about the disease pathogenesis and management and highlight the use of diagnosis and prognosis biomarkers. RECENT FINDINGS: Novel data strengthen the implication of endothelial function in PPCM pathogenesis. The first international registry showed that patient presentations were similar globally, with heterogeneity in patient management and outcome...
October 2018: Current Heart Failure Reports
Kate M Cohen, Rebecca D Minehart, Lisa R Leffert
PURPOSE OF REVIEW: This review summarizes the pathophysiology, peripartum treatment, and anesthetic management of parturients with cardiac disease. Valvular disease, coronary disease, and cardiomyopathy are specifically addressed in the context of the normal physiologic changes of pregnancy. We offer recommendations for anesthetic approaches, hemodynamic goals with an emphasis on interdisciplinary planning between anesthesiologists, cardiologists, cardiothoracic surgeons, obstetricians, maternal fetal medicine specialists, and neonatologists...
July 18, 2018: Current Treatment Options in Cardiovascular Medicine
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