Anesthetic considerations in the critically Ill gravida with cardiac disease

Shobana Murugan, Lisa Mouzi Wofford, Sandeep Markan, Yi Deng

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Anesthetic management in the critically ill parturient is determined largely by the nature of the presenting illness. This chapter discusses many common and uncommon cardiac diseases that may affect parturients in detail, with a focus on peripartum anesthetic management. Congenital heart disease (CHD), with small left-to-right intracardiac shunt, account for 60-80 percent of cardiac diseases in pregnant patients in the United States. Rheumatic mitral valve stenosis is the acquired heart disease frequently encountered in the pregnant population. Mitral valve insufficiency or regurgitation is the second most common valvular disease observed in pregnancy. The occurrence of aortic stenosis (AS) in pregnancy is rare, yet significant, given that pregnancy is a high-risk period for patients with aortic pathology. Arrhythmias usually worsen during pregnancy, so patients with a preexisting atrial tachyarrhythmia should consider ablation prior to conceiving. Cardiac surgery during pregnancy is usually reserved only for severe symptomatic valvular or aortic pathologies, given its high morbidity and mortality.

Original languageEnglish (US)
Title of host publicationCritical Care Obstetrics
Publisherwiley
Pages731-753
Number of pages23
ISBN (Electronic)9781119129400
ISBN (Print)9781119129370
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Keywords

  • Aortic stenosis
  • Arrhythmias
  • Cardiac diseases
  • Congenital heart disease
  • Peripartum anesthetic management
  • Regurgitation

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Murugan, S., Wofford, L. M., Markan, S., & Deng, Y. (2018). Anesthetic considerations in the critically Ill gravida with cardiac disease. In Critical Care Obstetrics (pp. 731-753). wiley. https://doi.org/10.1002/9781119129400.ch44