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急诊科的妊娠相关心脏病

Pregnancy-Related Heart Disease in the Emergency Department.

作者信息

Hodgson Nicole R, Lindor Rachel A, Monas Jessica, Heller Kimberly, Kishi Patrick, Thomas Aaron, Petrie Cody, Querin Lauren B, Urumov Andrej, Majdalany David S

机构信息

Mayo Clinic Department of Emergency Medicine, Phoenix, AZ 85054, USA.

Mayo Clinic Department of Emergency Medicine, Rochester, MN 55905, USA.

出版信息

J Pers Med. 2025 Apr 8;15(4):148. doi: 10.3390/jpm15040148.

Abstract

Pregnancy induces significant physiologic changes that impact the cardiovascular system, potentially exacerbating pre-existing cardiac conditions or precipitating new illnesses. Pregnant patients with cardiac emergencies pose unique challenges, as standard interventions may pose risks to the developing fetus. This article aims to enhance emergency physicians' confidence in managing pregnancy-related cardiac emergencies by providing a structured approach to initial evaluation and stabilization. We review eight common categories of pregnancy-associated cardiac illness: gestational hypertension and pre-eclampsia, cardiomyopathy, arrhythmias, valvular disease, aortopathies, congenital heart disease and pulmonary hypertension, coronary disease, and anticoagulation-related complications. For each condition, we summarize relevant pregnancy-specific pathophysiology and outline evidence-based, personalized emergency management strategies.

摘要

怀孕会引发显著的生理变化,这些变化会影响心血管系统,可能会使已有的心脏疾病恶化或引发新的疾病。患有心脏急症的孕妇带来了独特的挑战,因为标准的干预措施可能会对发育中的胎儿造成风险。本文旨在通过提供一种结构化的初始评估和稳定治疗方法,增强急诊医生处理与妊娠相关心脏急症的信心。我们回顾了与妊娠相关的八类常见心脏疾病:妊娠期高血压和子痫前期、心肌病、心律失常、瓣膜病、主动脉病变、先天性心脏病和肺动脉高压、冠状动脉疾病以及抗凝相关并发症。对于每种疾病,我们总结了相关的特定于妊娠的病理生理学,并概述了基于证据的个性化急诊管理策略。

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