Discover and read the best of Twitter Threads about #CardioObstetrics
Most recents (8)
1/Ms. Pregs is a G1P0 woman presenting to your clinic at 28 weeks. She has a history of hypertrophic cardiomyopathy (HCM). How should we manage her pregnancy?
Get ready for a fun #CardioObstetrics tweetorial from the @Cardionerds!
Get ready for a fun #CardioObstetrics tweetorial from the @Cardionerds!
2/I feel comfortable managing a pregnant patient who has HCM.
3/HCM is defined as LV wall thickness of ≥15 mm that is not explained by loading conditions (e.g., hypertension, valvular, congenital disease) or infiltrative cardiomyopathies.
Image: American Heart Assn
Image: American Heart Assn
A brief ‘Tweetorial’ for cardiologists / anyone who cares for patients who are or might become pregnant 🤰
as all of us have an increasingly important role to play in reproductive health
🧵 👇
1/9
as all of us have an increasingly important role to play in reproductive health
🧵 👇
1/9
2/9
In contrast with every other high-income country, maternal mortality has been rising in the U.S. for past 3 decades
and disproportionately affects Black women by 3- to 4-fold vs. White women
❗️70% of pregnancy-associated deaths are preventable❗️
In contrast with every other high-income country, maternal mortality has been rising in the U.S. for past 3 decades
and disproportionately affects Black women by 3- to 4-fold vs. White women
❗️70% of pregnancy-associated deaths are preventable❗️
3/9
What does this have to do with cardiology?
Hypertension, cardiovascular conditions, and stroke together now account for roughly half of maternal deaths
Cardiomyopathy = leading cause of pregnancy-associated death between 6 weeks and 1 year postpartum
What does this have to do with cardiology?
Hypertension, cardiovascular conditions, and stroke together now account for roughly half of maternal deaths
Cardiomyopathy = leading cause of pregnancy-associated death between 6 weeks and 1 year postpartum
Here are a couple of #ACC21 posters on pregnancy outcomes for women with heart disease, one from @LLUHealth on #CHD with RVOT dysfunction and one from @HopkinsMedicine on valvular heart disease, worth checking out. @doctorpianist @AllisonGHaysMD @kalamityjack #CardioObstetrics
In @abbykhanmd's talk Saturday, she highlighted three commonly used risk models for predicting adverse outcomes in pregnant women with heart disease: the modified WHO criteria, CARPREG II, and ZAHARA. #ACC21
Generally speaking, left-sided obstructive lesions (AS/MS) are known to impart the highest risk, while pulmonary valve disease and aortic regurgitation are regarded as relatively low risk and MR/TR fall somewhere in between. #ACC21
Starting off the Nuts & Bolts of Pregnancy and Congenital Heart Disease session with a pre-test question... #CardioObstetrics #ACC21 #ACHD
Keep this chart in mind. Pregnancy is a prolonged period of cardiovascular stress with increased cardiac output, plasma volume, and heart rate. Things get really interesting during labor/delivery with acute increases in BP and CO.
Various risk scores available: Modified WHO classification, CARPREG II, ZAHARA score. But clinical experience is extremely important since CHD patients are very heterogeneous and may not be well-represented in studies
#CardioNerds & #EPeeps, ready for an EKG Challenge⁉️⁉️
✍️Answer to follow on Monday 11/23 🗓️
🏥You see this 58 yo🧍♂️w/ ischemic CM in clinic.
🤔What's the rhythm❓
Brought to you by EKGaction: ekgaction.com
✍️Answer to follow on Monday 11/23 🗓️
🏥You see this 58 yo🧍♂️w/ ischemic CM in clinic.
🤔What's the rhythm❓
Brought to you by EKGaction: ekgaction.com
👆What's the rhythm? - please share!
@Dr_Markman @DrRachitaEP @JamesETooley @HussainMKCards @sshah008 @prkothapalli @kellyarps @AMohadjer_ @MaysAliMD @Ben_Kelemen @ElliottMillerMD @Nishant_ShahMD @aschenonegiugni @AjayPMD @divyangrpatel @djcantillonmd @Perrycardium @cardioPCImom
@Dr_Markman @DrRachitaEP @JamesETooley @HussainMKCards @sshah008 @prkothapalli @kellyarps @AMohadjer_ @MaysAliMD @Ben_Kelemen @ElliottMillerMD @Nishant_ShahMD @aschenonegiugni @AjayPMD @divyangrpatel @djcantillonmd @Perrycardium @cardioPCImom
Would you use a CardioNerds EKG Case of the Week - shared weekly?
Wonderful talk at #AHA10 @MarilynCipolla on #preeclampsia and the Brain #neuroobstetrics #cardioobstetrics @uvmvermont @MaryCushmanMD
🧠Preeclampsia is vascular disorder
🧠Preeclampsia defined below @acog
🧠Once you have PE, greater 🫀 events, HTN, DM
🧠 But also BRAIN effects
🧠Preeclampsia is vascular disorder
🧠Preeclampsia defined below @acog
🧠Once you have PE, greater 🫀 events, HTN, DM
🧠 But also BRAIN effects
#AHA20 #preeclampsia
🤰Preeclampsia is an exaggerated response of pregnancy induced inflammation, hyperlipidemia and hypercoagulation
⬆️ risk of:
🧠seizures
🧠stroke
🧠cognitive decline
🤰Preeclampsia is an exaggerated response of pregnancy induced inflammation, hyperlipidemia and hypercoagulation
⬆️ risk of:
🧠seizures
🧠stroke
🧠cognitive decline
#FITSurvivalGuide: CV disease in Pregnancy #CardioObstetrics
#Tweetorial for new #CardiologyFIT by @MonSangh and @JennLewey @Penn
1⃣CV Physiology
2⃣Peripartum CM
3⃣SCAD
4⃣Valve Dz
5⃣Aortopathy
6⃣Arrhythmias
7⃣HTN Disorders of 🤰
8⃣🤰& Future CV Risk
9⃣Drug Safety
#Tweetorial for new #CardiologyFIT by @MonSangh and @JennLewey @Penn
1⃣CV Physiology
2⃣Peripartum CM
3⃣SCAD
4⃣Valve Dz
5⃣Aortopathy
6⃣Arrhythmias
7⃣HTN Disorders of 🤰
8⃣🤰& Future CV Risk
9⃣Drug Safety
1⃣CV Physiology
**Major changes occur to meet metabolic & circulatory needs of 🚼.
🔸Hemodynamic: ⬇️SVR/BP ⬆️HR/CO ⬆️Plasma ↔️Filling pressure
🔸Structural: ⬆️Chamber/LV mass ⬆️Aortic Compliance
🔸Cardiometabolic: ⬆️Insulin resistance ⬆️Lipid/Trig
**Major changes occur to meet metabolic & circulatory needs of 🚼.
🔸Hemodynamic: ⬇️SVR/BP ⬆️HR/CO ⬆️Plasma ↔️Filling pressure
🔸Structural: ⬆️Chamber/LV mass ⬆️Aortic Compliance
🔸Cardiometabolic: ⬆️Insulin resistance ⬆️Lipid/Trig
2⃣Peripartum Cardiomyopathy
🔸Epi: Blacks>>White
🔸Cause: Double-hit hypothesis
🔸Dx: Idiopathic, EF < 45%, ~ 1 m prior or 5 m after delivery
🔸Rx: HF tx; metoprolol/enalapril safe for lactation; ?bromocriptine, ?lactation
🔸LVEF recovery 👍 future risk
🔸Anticoagulation
🔸Epi: Blacks>>White
🔸Cause: Double-hit hypothesis
🔸Dx: Idiopathic, EF < 45%, ~ 1 m prior or 5 m after delivery
🔸Rx: HF tx; metoprolol/enalapril safe for lactation; ?bromocriptine, ?lactation
🔸LVEF recovery 👍 future risk
🔸Anticoagulation
