Cardiovascular Diseases in Pregnancy – A Brief Overview

2021 ◽  
Vol 17 ◽  
Author(s):  
Ankit Kumar Sahu ◽  
Mullusoge Mariappa Harsha ◽  
Sonika Rathoor
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Heart Defects ◽  
Depth Information ◽  
Chronic Hypertension ◽  
Difficult Case ◽  
Case Scenario ◽  
Fertility Treatments ◽  
Increased Risk ◽  
Pregnancy And Heart Disease

: Even though, there have been many advances in maternal medical care and fertility treatments, the presence of cardiovascular disease has a significant impact on pregnancy. In pregnant women, several heart conditions, such as valvular heart disease, chronic hypertension, congenital heart defects and non-ischemic cardiomyopathies are linked to increased risk of fetal as well as maternal morbidity and mortality. To date, the management of the co-existing conditions of pregnancy and heart disease has been challenging. Therefore, an in-depth information may be beneficial to tackle a difficult case-scenario. Towards this end, this paper provides an overview of the recent updated knowledge of pregnancy-related cardiovascular diseases in women.

scholarly journals Congenital heart disease and pregnancy

2019 ◽  
Vol 4 (3) ◽  
pp. 102-112
Author(s):  
E. V. Rudaeva ◽  
V. G. Mozes ◽  
V. V. Kashtalap ◽  
I. S. Zakharov ◽  
S. I. Yelgina ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Intrauterine Growth Restriction ◽  
Congenital Malformations ◽  
Congenital Heart ◽  
Heart Defects ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Different Populations ◽  
European Society Of Cardiology

Annually, there > 30,000 infants are born with congenital heart defects; in different populations, the prevalence of congenital heart disease (CHD) varies from 2.4 to 14.15%. Women with CHD planning pregnancy are at increased risk of heart failure, arrhythmias, cerebrovascular disease, and embolism. In such patients, pregnancy course is complicated by intrauterine growth restriction, pre-eclampsia, and preterm birth. Their newborns generally have a low birth weight and high risk of congenital malformations including heart defects. European Society of Cardiology (ESC) developed risk assessment-based guidelines to optimise the management of pregnant women with CHD. This approach requires a cooperation of obstetrician-gynecologists, general practitioners, and cardiologists.

scholarly journals Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death Among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

2010 ◽  
Vol 31 (9) ◽  
pp. 1211-1229 ◽  
Author(s):  
Hilary M. Schwandt ◽  
Josef Coresh ◽  
Michelle J. Hindin
Keyword(s):  
Coronary Heart Disease ◽  
African American ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
African Americans ◽  
Marital Status ◽  
The United States ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk

Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine the relationship between African American men’s and women’s marital status and their risk of developing cardiovascular diseases and dying using the Atherosclerosis Risk in Communities (ARIC) data. After multivariable adjustment for individual characteristics and health status, we found that marital status was not associated with hypertension or new cases of CHD, but remaining single throughout the study period was associated with an increased risk of developing diabetes for women and an increased likelihood of death for men. Culturally appropriate interventions for African Americans are needed to decrease racial disparities in cardiovascular diseases and mortality.

Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data

2010 ◽  
Vol 40 (10) ◽  
pp. 1723-1733 ◽  
Author(s):  
M. Reis ◽  
B. Källén
Keyword(s):  
Congenital Malformations ◽  
Antidepressant Treatment ◽  
Heart Defects ◽  
Antidepressant Drugs ◽  
Antidepressant Medication ◽  
Tricyclic Antidepressant ◽  
Chronic Hypertension ◽  
Maternal Characteristics ◽  
Delivery Outcome ◽  
Increased Risk

BackgroundConcerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations.MethodData from the Swedish Medical Birth Register (MBR) from 1 July 1995 up to 2007 were used to identify women who reported the use of antidepressants in early pregnancy or were prescribed antidepressants during pregnancy by antenatal care: a total of 14 821 women with 15 017 infants. Maternal characteristics, maternal delivery diagnoses, infant neonatal diagnoses and the presence of congenital malformations were compared with all other women who gave birth, using the Mantel–Haenszel technique and with adjustments for certain characteristics.ResultsThere was an association between antidepressant treatment and pre-existing diabetes and chronic hypertension but also with many pregnancy complications. Rates of induced delivery and caesarean section were increased. The preterm birth rate was increased but not that of intrauterine growth retardation. Neonatal complications were common, notably after tricyclic antidepressant (TCA) use. An increased risk of persistent pulmonary hypertension of the newborn (PPHN) was verified. The congenital malformation rate was increased after TCAs. An association between use of paroxetine and congenital heart defects was verified and a similar effect on hypospadias was seen.ConclusionsWomen using antidepressants during pregnancy and their newborns have increased pathology. It is not clear how much of this is due to drug use or underlying pathology. Use of TCAs was found to carry a higher risk than other antidepressants and paroxetine seems to be associated with a specific teratogenic property.

scholarly journals Association between maternal obesity and metabolic disorders and congenital heart defects in the offspring: a literature review

2020 ◽  
Author(s):  
Gitte Hedermann ◽  
Paula L Hedley ◽  
Ida N Thagaard ◽  
Lone Krebs ◽  
Thorkild IA Sørensen ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Metabolic Disorders ◽  
Maternal Obesity ◽  
Heart Defects ◽  
Chronic Hypertension ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
Early Onset Preeclampsia ◽  
The Individual

SummaryCongenital heart defects (CHDs) are the most common congenital malformation and will, in severe cases, have a serious impact on neonatal mortality and morbidity. The aetiology of CHDs is complex. Large cohort studies have reported an association between increased risk of CHDs in the offspring and individual maternal metabolic disorders such as diabetes, hypertension, preeclampsia, and obesity. All conditions that can be related to insulin resistance and possibly metabolic syndrome (MetS). The aim of this review is to evaluate the existing evidence on the association between maternal metabolic disorders, defined as obesity, diabetes, hypertension, preeclampsia, dyslipidaemia, and MetS, or combinations thereof and CHDs in the offspring. A literature search was performed using PubMed and Embase databases. Of the 2,076 potentially relevant identified studies, 30 qualified for inclusion. Only one study dealt with the combination of more than one maternal metabolic condition as risk factor for CHDs in the offspring. All other studies investigated the individual metabolic disorders and their association with CHDs. Some disorders (chronic hypertension, gestational diabetes, and obesity) increased risk of CHDs marginally whereas pregestational diabetes and early-onset preeclampsia were highly associated with CHDs. Future studies on the combination of several metabolic disorders in the same pregnancy and their association with CHDs are needed.

Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses

2020 ◽  
Vol 100 (1) ◽  
pp. 37-49 ◽  
Author(s):  
M. Romandini ◽  
G. Baima ◽  
G. Antonoglou ◽  
J. Bueno ◽  
E. Figuero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Cerebrovascular Diseases ◽  
Increased Risk ◽  
Study Results ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Meta Analyses

Periodontitis has been independently associated with the chronic noncommunicable diseases that most frequently lead to death worldwide. The aim of the present systematic review was to study whether people with periodontitis/edentulism are at increased risk of all-cause and cause-specific mortality as compared with those without periodontitis/edentulism. Cohort studies were included that 1) evaluated periodontitis or edentulism as exposures in relation to all-cause or cause-specific mortality as an outcome and 2) reported effect estimates as hazard ratios, risk ratios, or odds ratios with 95% CIs or crude numbers. Two review authors independently searched for eligible studies, screened the titles and abstracts, did full-text analysis, extracted the data from the published reports, and performed the risk-of-bias assessment. In case of disagreement, a third review author was consulted. Study results were summarized through random effects meta-analyses. A total of 57 studies were included, involving 48 cohorts and 5.71 million participants. Periodontitis was associated with increased risk of all-cause mortality (risk ratio, 1.46 [95% CI, 1.15 to 1.85]) and mortality due to cardiovascular diseases (1.47 [1.14 to 1.90]), cancer (1.38 [1.24 to 1.53]), coronary heart disease (2.58 [2.20 to 3.03]), cerebrovascular diseases (3.11 [2.42 to 3.98]), but not pneumonia (0.98 [0.69 to 1.38]). Edentulism (all types) was associated with increased risk of all-cause mortality (1.66 [1.46 to 1.88]) and mortality due to cardiovascular diseases (2.03 [1.50 to 2.74]), cancer (1.55 [1.24 to 1.94]), pneumonia (1.72 [1.07 to 2.78]), coronary heart disease (2.98 [2.43 to 3.65]), and cerebrovascular diseases (3.18 [2.24 to 4.51]). Periodontitis and its ultimate sequela (edentulism) are associated with an increased risk of all-cause and cause-specific mortality (PROSPERO CRD42018100095).

scholarly journals COVID-19 in pregnant women with heart diseases. Adverse maternal and fetal outcomes. Case series from InCor registry of Pregnancy and Heart Disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M R Kirschbaum ◽  
M S Devido ◽  
E Azeka ◽  
L M M F Demarchi ◽  
J S Santos ◽  
...  
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Heart Diseases ◽  
Case Series ◽  
Childbearing Age ◽  
Fetal Outcomes ◽  
Worst Case ◽  
Increased Risk ◽  
Co Morbidity ◽  
Pregnancy And Heart Disease

Abstract Background Heart disease is the leading non-obstetric cause of maternal death during pregnancy. In this field, the emergence of pandemic COVID-19 has caused the worst-case scenario considering that pregnant women are more susceptible to viral infections, and preexisting cardiac disease is the most prevalent co-morbidity among COVID-19 deaths. Purpose To assess the maternal and fetal outcomes of COVID-19 during pregnancy of women with heart diseases. Methods During the year 2020, among 82 pregnant women with heart disease followed consecutively at the Instituto do Coração-InCor, seven of them with an average age of 33.2 years had COVID-19 during their pregnancies. The underlying heart diseases were rheumatic valve disease (5 pt), congenital heart disease (1 pt) and one case with acute myocarditis, without preexisting cardiopathy. The prescription (antibiotics, inotropes, corticosteroids and others) used was according to the clinical conditions required for each patient, however subcutaneous or intravenous heparin was used in all patients. Results Only one case had an uneventful maternal-fetal course, the other six women required hospitalization / ICU for an average of 25.3 days, including the need for mechanical ventilation in two of them. Serious complications were related to respiratory failure (ADRS), recurrent atrial flutter with hemodynamic instability, acute pulmonary edema, and cardiogenic shock associated with sepsis which caused two maternal deaths. There were two emergency mitral valve interventional, percutaneous balloon valvuloplasty and valve bioprosthesis replacement, respectively. There were five premature births with an average gestational age of 34.2 weeks of gestation, which resulted in one stillbirth. Pathological findings of three placental and the six-months follow-up of the babies did not confirm vertical transmission of COVID-19. Conclusions The uncertain evolution given of the overlapping complications of three conditions – COVID-19, pregnancy, and heart disease – implies an increased risk for women with heart diseases of childbearing age, for whom pregnancy should be discouraged and planned after vaccination FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Association between apolipoprotein B and dietary fibers

2021 ◽  
Vol 4 (2) ◽  
pp. 73-83
Author(s):  
Almira Devina Gunawan ◽  
Saptawati Bardosono ◽  
Ninik Mudjihartini
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Dietary Fiber ◽  
Apolipoprotein B ◽  
Natural Fibers ◽  
Experimental Studies ◽  
Fiber Intake ◽  
Dietary Fibers ◽  
Increased Risk ◽  
The Relationship

Introduction Global awareness to the importance of natural fibers in vegetables and fruits are still generally very low. Indonesian people consume less fibers, which has been associated with the development of heart disease. Heart disease has been known as the leading cause of morbidity and mortality. Apolipoprotein B (ApoB) is a component of atherogenic particles that can be used as a marker for an increased risk of cardiovascular disease. Researches on apoB profile and its relationship with fiber intake has provided inconsistent results. This is an article review of the current literatures on the relationship between dietary fiber and serum apoB levels. Methods: This is an article review of the current literatures on the relationship between dietary fiber and apoB. We searched PubMed and Google Scholar using keyword “dietary fibers” and “ApoB” to capture meta-analyses, observational and experimental studies. A total of 97 publication and abstracts were screened for this review. After careful screening, nine studies were finally included. Results: Two studies did not find associations between dietary fiber and serum apoB, while other seven found the association. Dietary fiber has been reported to be involved in the metabolism of serum cholesterol and blood pressure; hence, the deficiency of dietary fiber intake is believed to contribute to the epidemic of cardiovascular diseases. Several factors including nutritional status, dietary diet pattern, age, gender, physical activity, and smoking habits might influence the relationship between dietary fiber and serum apoB. Conclusion: More studies are required in the future for better understanding on the effect of dietary fiber on the apoB; hence, the risk of cardiovascular diseases.

scholarly journals Cardiac Complications during Pregnancy Related to Parity in Women with Congenital Heart Disease

Cardiology ◽  
2020 ◽  
Vol 145 (8) ◽  
pp. 533-542
Author(s):  
Eva Furenäs ◽  
Peter Eriksson ◽  
Ulla-Britt Wennerholm ◽  
Mikael Dellborg
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Defects ◽  
Adult Congenital Heart Disease ◽  
Cardiac Complications ◽  
Increased Risk ◽  
Adult Congenital ◽  
Per Se

Objective: To describe the frequency of cardiac complications during pregnancy related to parity in women with congenital heart defects. Methods: A retrospective tertiary single-center study at the Adult Congenital Heart Disease Centre that followed 307 women with congenital heart disease during the years 1997–2015 in Gothenburg, Sweden. Ma­ternal cardiac complications were noted for each pregnancy using medical and obstetric records. The CARPREG I and modified WHO (mWHO) risk classifications were used. Twin pregnancies, miscarriages before gestational week 13, and pregnancy terminations were excluded. Results: Five hundred seventy-one deliveries and 9 late miscarriages were analyzed. The mean parity was 1.74 per woman (range 1–8). Eighty-four (14.6%) maternal cardiac complications were experienced; arrhythmia (5.7%) and heart failure (4.4%) being the most prevalent, and there was 1 maternal death. Heart failure occurred during the first pregnancy in 12 women (3.9%), in the second pregnancy in 8 women (4.3%), and in the third pregnancy in 4 women (7.7%). CARPREG I and mWHO scores were associated with an increased risk of having a cardiac complication, while parity per se was not associated. The OR for having a maternally uneventful second pregnancy if the first pregnancy was without cardiac complications was 5.47 (95% CI 1.76–16.94) after controlling for CARPREG I and mWHO scores. Conclusion: The risk of severe maternal cardiac complications during pregnancy in women with congenital heart disease is low. In this largest analysis to date with a focus on parity in 307 women, the risk classification predicts the maternal outcome more than parity per se. If the first pregnancy is uneventful, the OR is 5.5 for an uneventful second pregnancy if CARPREG I and mWHO scores remain unchanged.

scholarly journals Features of Antithrombotic Therapy in Patients with Multifocal Arterial Disease

Kardiologiia ◽  
2021 ◽  
Vol 61 (3) ◽  
pp. 87-95
Author(s):  
V. G. Grachev ◽  
S. S. Vedenskaya ◽  
O. G. Smolenskaya
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Antithrombotic Therapy ◽  
Arterial Disease ◽  
Arterial Injury ◽  
Cardiovascular Complications ◽  
Peripheral Artery ◽  
Increased Risk ◽  
Atherosclerotic Cardiovascular Diseases ◽  
Peripheral Artery Diseases

Multifocal arterial injury is common in patients with atherosclerotic cardiovascular diseases and is associated with increased risk of cardiovascular complications and death. Administration of more intensive antithrombotic therapy, particularly combinations of acetylsalicylic acid and a “vascular” dose of rivaroxaban, in patients with multifocal arterial injury is characterized by a beneficial ratio of efficiency and safety due to a pronounced decrease in the risk of cardiovascular complications. Detection of peripheral artery diseases in patients with ischemic heart disease and atherosclerotic cerebrovascular pathology makes it possible to improve the risk stratification, optimize the diagnostic tactics and clarify indications for more intensive antithrombotic therapy.

scholarly journals THE IMPORTANCE OF COMPENSATION OF MICRONUTRIENT DEFICIENCIES IN PERSONS WITH CARDIOVASCULAR DISEASES IN THE ERA OF COVID-19

2020 ◽  
Vol 18 (6) ◽  
pp. 750-754
Author(s):  
L. V. Yakubova ◽  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
The Body ◽  
Published Data ◽  
Micronutrient Deficiencies ◽  
Daily Consumption ◽  
Cvd Risk ◽  
Increased Risk

According to a number of studies, patients with cardiovascular diseases (CVD) have an increased risk of adverse course and death from COVID-19. The deficiency in the daily consumption of micronutrients, especially potassium and magnesium, is considered to be a non-infectious "epidemic" of the 21st century. The paper presents the results of studies indicating an increased risk of developing CVD (arterial hypertension, ischemic heart disease, myocardial infarction, stroke, arrhythmias) and mortality from them in the presence of a deficiency in the consumption of potassium and magnesium, as well as their reduced content in the body. It provides an overview of published data on the importance of maintaining normal levels of potassium and magnesium in the body to reduce CVD risk and mortality.

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