Cardiac Arrhythmia in Pregnant Women
Jul 10, 2018
The heart muscle, or as it is called - the myocardium, when contracted, causes the blood to move, supplying tissues and organs with vital oxygen and essential nutrients. Under normal conditions, this movement occurs with a certain rhythm, and the pulse rate is usually from 60 to 80 times per minute.
Cardiac arrhythmia is a change in the frequency, rhythm, strength, and sequence of heartbeats.
Changing the rhythm of heartbeat can occur for completely different reasons. Often they are a consequence of diseases of the autonomic and central nervous system. But in most cases this is a lesion of the myocardium and the conducting system.
Cardiac arrhythmias in pregnant women are of several types, we will consider each of them in more detail.
This type of arrhythmia in pregnancy can be expressed in premature atrial contraction, ectopic atrial tachycardia, and prolonged paroxysmal supraventricular tachycardia or, in short, PSVT.
Despite the fact that atrial fibrillation in the absence of any structural heart disease is a rare phenomenon, this arrhythmia can arise both primarily and significantly worsen, if the diagnosis was made earlier.
To date, there is only a theoretical explanation of this issue. All the blame for emotional, hemodynamic and hormonal changes in the female body.
- Increased blood volume, is a consequence of increased sensitivity of the myocardium;
- Sinus rhythm amplification increases and stabilizes pulse return;
- Estrogens excite muscle fibers of the heart.
Ventricular arrhythmias include ectopia, tachycardia, and atrial extrasystole. They are provoked by those factors that have been described above, as well as the worsening of tolerance due to pregnancy.
Ventricular tachycardia, the most common heart failure in patients without cardiac pathologies, is of several types:
- Monomorphic, recurrent tachycardia with left bundle blockade of the heartbeat of Guiss;
- Idiopathic tachycardia of the left ventricle;
Very rare cases are arrhythmias in consequence of ideopathic or ischemic cardiomyopathy.
The only known case was a tachycardia associated with the Romano-Ward syndrome, in which an increase in the QT interval is observed.
Symptomatic bradycardia is associated with the fact that increasing, the uterus squeezes the lower vena cava. Thus the inflow of blood to the heart decreases, and the heart rate slows down.
- The bradycardia is of three kinds:
- Relative - in which, the heart rate is somewhat behind the established norms for these conditions.
- Absolute - permanent, systematic reduction of the heart rate.
- Moderate - this type of bradycardia in pregnant women is very rare and is usually associated with a violation of breathing.
Such arrhythmia in pregnancy usually does not cause such complaints.
Congenital cardiac blockade of
In pregnant women, the arrhythmia of this species extremely rarely complicates their position and is diagnosed, as a rule, by accident. With a significant increase in symptoms, patients with this diagnosis are usually prescribed temporary prophylactic stimulation. In case of emergency, it is possible to implant the patient with a permanent pacemaker at any time of pregnancy.
Any of the listed types of arrhythmia has nothing to do with abortion. In this case, delivery takes place naturally or in accordance with the indications for the main type of disease, if any.
Treatment of pregnant women with pronounced dysfunction of the heart muscle should take place in tandem as an obstetrician and cardiologist. It is necessary to carefully select the methods of treatment with an eye on the possible effects of drugs on the development of the fetus.