Summary
Highlights
The video introduces the two most common heart diseases complicating pregnancy: congenital heart diseases (present from birth) and rheumatic heart disease (resulting from untreated beta-hemolytic streptococcal infection).
Common symptoms include dyspnea, orthopnea, palpitations, and chest pain. Signs observed can be cyanosis, clubbing, thrill, murmurs, and arrhythmias (detected by ECG).
Pregnancy causes physiological cardiovascular changes, such as increased cardiac output, stroke volume, and heart rate, along with decreased peripheral vascular resistance and blood pressure. A normal heart can adapt, but a diseased heart will struggle.
The New York Heart Association (NYHA) classification categorizes heart disease severity from Class 1 (no limitation of daily activity) to Class 4 (severe limitation, dyspnea at rest), indicating the patient's capacity for physical activity.
Rheumatic heart disease, primarily caused by untreated streptococcal infection, most commonly affects the mitral valve, leading to mitral stenosis. This narrowing can cause pulmonary hypertension, pulmonary edema, and atrial fibrillation, increasing mortality risk.
Surgical intervention is preferred before pregnancy. During pregnancy, balloon valvuloplasty can dilate the narrowed mitral valve. Lifestyle changes such as limited physical activity, salt restriction, and diuretics for edema are also recommended.
Common congenital heart diseases like Atrial Septal Defects (ASD), Ventricular Septal Defects (VSD), and Patent Ductus Arteriosus (PDA) are generally not high-risk during pregnancy if treated. However, Tetralogy of Fallot, if uncorrected, poses a high risk of threatened abortion and maternal/fetal survival due to right-to-left shunting.
Congenital heart defects can be genetic, increasing risk for the fetus if either parent has the condition. Counseling is important to inform parents about these risks.
In developed countries, rheumatic heart disease incidence is decreasing due to antibiotic use, and congenital defects are better managed with improved surgery. In contrast, developing and underdeveloped countries still face significant challenges with both conditions due to lack of treatment access, posing similar threats to pregnancy.