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[妊娠期中度或重度后天性心脏瓣膜病——决定治疗方案的因素是什么?经验、直觉还是指南?]

[Moderate or severe aquired valvular heart disease in pregnancy--what does determine the management? Experence, intuition or guidelines?].

作者信息

Greszata Lidia, Stępińska Janina

出版信息

Przegl Lek. 2015;72(4):189-92.

Abstract

Epidemiology of acquired valvular heart diseases has changed significantly over last decades. Degenerative aortic valve stenosis is the most common acquired valvular disease with high prevalence in elderly population. Another common disorder is ischemic mitral regurgitation secondary to myocardial infarction. Both above-mentioned heart disorders are not typical for women in reproductive age. Rheumatic heart valve disease has become infrequent in Polish population. Mitral stenosis, the most prevalent of rheumatic valvular disorders, affects 5% of pregnant women with heart disease and rheumatic aortic stenosis is responsible for 0.5-3% of heart diseases in this population. Despite the fact that acquired valvular disorders are becoming less common among pregnant women, they still remain an important issue and their management should be well known. Discussion about pregnancy should be a part of management of young women with valvular heart disease. Severe valve disorders should be corrected when planning pregnancy. The final management should always be based on collaborative decision made by the patient and health professionals.

摘要

在过去几十年中,获得性心脏瓣膜病的流行病学发生了显著变化。退行性主动脉瓣狭窄是最常见的获得性心脏瓣膜病,在老年人群中患病率很高。另一种常见疾病是继发于心肌梗死的缺血性二尖瓣反流。上述两种心脏疾病在育龄女性中并不常见。风湿性心脏瓣膜病在波兰人群中已变得不常见。二尖瓣狭窄是最常见的风湿性瓣膜疾病,影响5%患有心脏病的孕妇,风湿性主动脉瓣狭窄占该人群心脏病的0.5%-3%。尽管获得性瓣膜疾病在孕妇中越来越不常见,但它们仍然是一个重要问题,其管理方法应该广为人知。关于妊娠的讨论应该成为患有心脏瓣膜病的年轻女性管理的一部分。在计划怀孕时,严重的瓣膜疾病应该得到纠正。最终的管理决策应该始终基于患者和医疗专业人员共同做出的决定。

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