Vol 60, No 3 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Changes in the cardiovascular system during pregnancy in females with secundum atrial septal defect

Wojciech Piesiewicz, Aleksander Goch, Zbigniew Binikowski, Urszula Faflik, Grzegorz Krasomski, Jan Goch
Kardiol Pol 2004;60(3):224-228.
Vol 60, No 3 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: The secundum atrial septal defect (ASD II) is, after bicuspid aortic valve, the second most frequent congenital heart disease. In the majority of females with ASD II the course of pregnancy is uncomplicated, however, pregnancy-related cardiovascular changes may affect haemodynamical parameters of the defect.
Aim: To assess cardiovascular changes in pregnant females with ASD II.
Methods: The study group consisted of 54 pregnant females with ASD II and 30 control healthy pregnant women. NYHA class, standard ECG, 24-hour ambulatory ECG monitoring and echocardiography were analysed in the second and third trimester of pregnancy as well as during puerperium.
Results and conclusions: (1) Due to the relatively small sample of population studied and limitations of the usage of NYHA classification in pregnant women, the relationship between ASD II and the development of heart failure during pregnancy could not be definitely proved. (2) An increase in the right ventricular and right atrial enlargement was significantly greater in pregnant women with ASD II compared with healthy pregnant females. Also indirect parameters of the right ventricular strain (paradoxical systolic movement of the interventricular septum or tricuspid regurgitation) were more frequent in patients with ASD II rather than in controls. These alterations were accompanied by a significant decrease in the mean value of the Qp/Qs index which may suggest pregnancy-related favourable changes in the haemodynamical consequences of the defect - a decrease in the left-to-right shunt. (3) Paroxysmal supraventricular tachycardia was the most frequent cardiac arrhythmia in pregnant women with ASD II.

Abstract

Background: The secundum atrial septal defect (ASD II) is, after bicuspid aortic valve, the second most frequent congenital heart disease. In the majority of females with ASD II the course of pregnancy is uncomplicated, however, pregnancy-related cardiovascular changes may affect haemodynamical parameters of the defect.
Aim: To assess cardiovascular changes in pregnant females with ASD II.
Methods: The study group consisted of 54 pregnant females with ASD II and 30 control healthy pregnant women. NYHA class, standard ECG, 24-hour ambulatory ECG monitoring and echocardiography were analysed in the second and third trimester of pregnancy as well as during puerperium.
Results and conclusions: (1) Due to the relatively small sample of population studied and limitations of the usage of NYHA classification in pregnant women, the relationship between ASD II and the development of heart failure during pregnancy could not be definitely proved. (2) An increase in the right ventricular and right atrial enlargement was significantly greater in pregnant women with ASD II compared with healthy pregnant females. Also indirect parameters of the right ventricular strain (paradoxical systolic movement of the interventricular septum or tricuspid regurgitation) were more frequent in patients with ASD II rather than in controls. These alterations were accompanied by a significant decrease in the mean value of the Qp/Qs index which may suggest pregnancy-related favourable changes in the haemodynamical consequences of the defect - a decrease in the left-to-right shunt. (3) Paroxysmal supraventricular tachycardia was the most frequent cardiac arrhythmia in pregnant women with ASD II.
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Keywords

pregnancy - secundum atrial septal defect

About this article
Title

Changes in the cardiovascular system during pregnancy in females with secundum atrial septal defect

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 60, No 3 (2004)

Pages

224-228

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2004;60(3):224-228.

Keywords

pregnancy - secundum atrial septal defect

Authors

Wojciech Piesiewicz
Aleksander Goch
Zbigniew Binikowski
Urszula Faflik
Grzegorz Krasomski
Jan Goch

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