Document Detail

Management of the critically ill cardiac patient.
MedLine Citation:
PMID:  11478813     Owner:  NLM     Status:  MEDLINE    
The decline in rheumatic fever has made heart disease in pregnancy an uncommon problem in the developed world but it remains an important cause of maternal morbidity and mortality in developing countries. Pregnancy is particularly dangerous in the presence of cyanotic congenital heart disease, Eisenmenger's syndrome, primary pulmonary hypertension, Marfan's syndrome, dilated cardiomyopathy and significant mitral stenosis. Severe stenosis is often complicated by pulmonary hypertension and atrial fibrillation. Maternal disease status should be determined using echocardiography to define cardiac anatomy, assess ventricular function and estimate intracardiac pressure gradients. Patients in the New York Heart Association functional classes 1 and 2 generally have a favourable outcome. Closed mitral commissurotomy is safe and effective in relieving stenosis across the mitral valve in selected patients. More recently the technique of percutaneous balloon mitral valvotomy has successfully been used in the treatment of mitral stenosis. Termination of pregnancy is advised in patients with severe pulmonary hypertension, including Eisenmenger's syndrome.
D P Naidoo; J Moodley
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Best practice & research. Clinical obstetrics & gynaecology     Volume:  15     ISSN:  1521-6934     ISO Abbreviation:  Best Pract Res Clin Obstet Gynaecol     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-07-31     Completed Date:  2001-09-13     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  101121582     Medline TA:  Best Pract Res Clin Obstet Gynaecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  523-44     Citation Subset:  IM    
Copyright Information:
Copyright 2001 Harcourt Publishers Ltd.
Cardiac Unit, Department of Medicine, King Edward VII Hospital, The Medical School, Durban, Natal, South Africa.
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MeSH Terms
Critical Illness / therapy
Heart Diseases / therapy*,  ultrasonography
Pregnancy Complications, Cardiovascular / therapy*,  ultrasonography
Puerperal Disorders / therapy

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