GOOD

MORNING

CARDIO VASCULAR
DISEASES
Presented By
Manpreet Kaur
M.Sc.[N] 2nd Yr

CARDIO VASCULAR
DISEASES
Changes in Cardiovascular
Dynamics during
Pregnancy:
An increase in cardiac output by 30 to 50 %
An increase in blood volume by 20 to 40 %
A rise in stroke volume by 20 to 40 % in
early pregnancy
A fall in the blood pressure in the second

Incidence
The overall incidence of cardiac
diseases in pregnancy is falling in
both developing parts of the world. It
is less than 1% in hospital deliveries

Factors Responsible For Cardio Failure

Advanced age
Cardiac arrhythmias
History of previous heart failure
Appearance of risk factor in
pregnancy
Inadequate supervision

Effects on Heart Lesion on Pregnancy

Preterm delivery
Prematurity
IUGR is quite common in cyanotic heart
diseases

GRADING

Clinical findings
Lateral displacement of the heart occurs in
late pregnancy
Soft systolic murmur is sometimes heard
A diastolic murmur, a harsh systolic
murmur and fibrillation

INVESTIGATIONS

Cont

X- ray
ECG
Doppler ultrasound

Complication
Maternal Complication: Pulmonary edema
Congestive cardiac failure
Pulmonary emboli and thrombosis
Subacute bacterial endocarditics

The fetal complications are:

Preterm labor

ANTENATAL CARE
The following advices are given to the women:
Adequate rest

CONT

Hospitalization

Intranatal Care: 1st stage of labor

Careful
Cardiac
watch
monitoring
of theand
pulse
pulse
and respiration
Fluids
Analgesia
Oxygen
Position

CONT

The second stage of labor:

Forceps or Ventouse under

pudendal or perineal block
anaesthesia
Intravenous
ergometrine
with the delivery of the
anterior shoulder should be

CONT

The third stage of labor:

No ergot containing preparation should
be used for the 3rd stage of labor
If the blood loss is excess, syntocinon
may be used as it has less effect on
blood vessels than ergometrine
If the women is in heart failure,
oxytocics should be avoided
If syntocinon is given by infusion
accompanied by intravenous frusemide

Postnatal care:
Patient
Patientisistotobe
beobserved
observedclosely
closelyfor
forthe
thefirst
first
24
24hours
hours
Oxygen
in
administered
Oxygen in administered
Breast
Breast feeding
feeding isis not
not contraindicated
contraindicated unless
unless
there
thereisisfailure
failure
Anticoagulant
Anticoagulant therapy
therapy isis not
not aa
contraindication
contraindicationofofbreast
breastfeeding
feeding

Management of cardiac failure in pregnancy

Propped up position
Injection morphine 15 mg IM
Monitoring with ECG and pulse
oxymetery
Diuretic- frusemide (loop) 40-80mg
I.V
Oxygen administration
Digoxin 0.5 mg I.M. followed by

Summarization
Cardiovascular changes
Types
Gradings
Clinical features
Investigation
Management

THANKS