Department of Medicine, Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, Cardiology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Can J Cardiol. 2021 Dec;37(12):2076-2079. doi: 10.1016/j.cjca.2021.09.019. Epub 2021 Sep 24.
Cardiovascular disease is now the leading cause of maternal mortality in the industrialised nations. This public health crisis is driven by a variety of factors, including advancing maternal age, increasing prevalence of diabetes and hypertension and the growing number of adults with congenital heart disease. To meet the needs of this complex and diverse population, the subspecialty of cardio-obstetrics has developed. By its very nature, cardio-obstetrics is a team endeavour and requires contributions from multiple disciplines to deliver optimal care. In this article, we argue that cardio-obstetrics is not a niche issue. The magnitude of the current health challenges makes it imperative that all physicians who care for women of childbearing age have a basic knowledge of how cardiovascular disease can impart risk to women during and beyond pregnancy. We address how to increase awareness within the general medical community so that health care workers are able to recognise potential issues and are aware of how to refer to appropriate specialists. We discuss how to incorporate this within cardiology training so that general cardiologists consider the implications that pregnancy has on their patients. And we reflect on the training of the obstetric cardiologists of tomorrow as this field continues to evolve.
心血管疾病现在是工业化国家产妇死亡的主要原因。这一公共卫生危机是由多种因素驱动的,包括产妇年龄的增长、糖尿病和高血压的患病率增加以及患有先天性心脏病的成年人数量不断增加。为了满足这个复杂多样人群的需求,已经发展出了妇产科心脏病学这一分支学科。从本质上讲,妇产科心脏病学是一项团队努力,需要多个学科的贡献,以提供最佳的护理。在本文中,我们认为妇产科心脏病学不是一个利基问题。当前健康挑战的规模使得所有照顾育龄妇女的医生都必须了解心血管疾病如何在妊娠期间和之后对妇女带来风险。我们探讨了如何在普通医疗社区中提高认识,以便医疗保健工作者能够识别潜在问题,并了解如何向适当的专家转诊。我们讨论了如何将这一点纳入心脏病学培训,以便普通心脏病专家考虑到妊娠对其患者的影响。我们还反思了未来妇产科心脏病专家的培训,因为这个领域还在不断发展。