Abstract

BARRANCO, Daniela; MAGLIONE, Florencia  and  PEREZ, Silvia. Cardiomyopathy, heart failure and pregnancy. An increasing problem. Rev.Urug.Cardiol. [online]. 2024, vol.39, n.1, e303.  Epub Dec 01, 2024. ISSN 0797-0048.  https://doi.org/10.29277/cardio.39.1.11.

Cardiovascular disease is one of the most serious complications during pregnancy. Heart failure in pregnancy is rare, but when it occurs it can be fatal, being an increasing cause of maternal mortality in pregnancy. Cardiomyopathies that affect pregnancy can be dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic dysplasia, stress-related, toxic-induced, or cardiotoxicity. Peripartum cardiomyopathy is an exclusion entity, which presents at the end of the third trimester or in the first 6 months postpartum as a new drop in the left ventricular ejection fraction below 45%. The physiological changes of pregnancy often mask up the symptoms of heart failure and a high level of suspicion is required in pregnant women to make a diagnosis. Concerning the treatment, it requires special considerations ensuring maternal and fetal safety, so not all drugs for heart failure can be used. The use of bromocriptine has a precise indication. Support with external mechanical assistance devices can help reverse cardiogenic shock when heart failure is severe or allow for heart transplantation. Prior and future gestational counselling in women with heart disease can reduce the incidence of this serious disease.

Keywords : CARDIOMYOPATHY; HEART FAILURE; PREGNANCY.

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