Heart Damage in Pregnancies Complicated with Preeclampsia: Case Report

I. Kjaev, S. Jovanova, Jana Nivicka Kjaeva, D. Karadjova, Irena Aleksioska, S. Kjaeva, R. Spasova, Goran Kocoski
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Abstract

Abstract Introduction. Heart function in pregnancy is a subject of many debates and studies. A large number of epidemiologic studies have found association between preeclampsia and cardiovascular morbidity/mortality. About 5-8% of deliveries are complicated with preeclampsia. Until recently, heart damage associated with preeclampsia has not been studied. A number of heart difficulties only appear long after the reproduction period has ended. Preeclampsia increases the risk for B stage (asymptomatic) of heart failure. Case report. A 37-year-old pregnant patient, G2P1 27 weeks of gestation, paid her first visit to the Gynecology Outpatient Clinic. She complained on heavy breathing, difficulty with movement and hypertension. She was referred for further evaluation to the Cardiology Outpatient Clinic with a suspicion of gestational hypertension and heart abnormalities. The pregnancy was evaluated several times at the Out-patient Clinics of Gynecology and Cardiology with the diagnosis of gestational hypertension. Echocardiography showed abnormal heart remodeling. In the 36 g.w laboratory findings showed urine dip stick ++,ТА160/110. The diagnosis was changed to preeclampsia. The patient was delivered with a re-caesarean section because of previous S.C and preeclampsia. Postpartum echocardiography confirmed left chamber hypertrophy with persistent hypertension. Results. Clinical cardiovascular complications in preeclampsia continue long after the pregnancy has ended. Studies show that pregnancies with both early and late preeclampsia have an increased risk for asymptomatic left chamber dysfunction/hypertrophy and essential hypertension in the next 2 years after delivery. If the damages are caught early prevention can be started sooner rather than later before patients become symptomatic (C stage of heart failure).
妊娠合并子痫前期心脏损伤1例报告
摘要介绍。怀孕期间的心脏功能是许多争论和研究的主题。大量流行病学研究发现子痫前期与心血管疾病发病率/死亡率之间存在关联。大约5-8%的分娩伴有先兆子痫。直到最近,与子痫前期相关的心脏损伤还没有被研究过。一些心脏问题在生育期结束后很久才会出现。先兆子痫增加B期(无症状)心力衰竭的风险。病例报告。37岁孕妇,G2P1,妊娠27周,首次到妇科门诊就诊。她主诉呼吸沉重、行动困难和高血压。由于怀疑妊娠高血压和心脏异常,她被转到心脏病科门诊进行进一步评估。妊娠在妇科和心脏科门诊进行了多次评估,诊断为妊娠高血压。超声心动图显示心脏重构异常。在36g.w实验室检查结果显示尿浸棒++,ТА160/110。诊断改为子痫前期。由于先前的sc和先兆子痫,患者再次剖腹产。产后超声心动图证实左室肥厚伴持续性高血压。结果。子痫前期的临床心血管并发症在妊娠结束后仍持续很长时间。研究表明,早期和晚期子痫前期妊娠在分娩后2年内发生无症状左室功能障碍/肥厚和原发性高血压的风险增加。如果及早发现损害,可以在患者出现症状(C期心力衰竭)之前尽早开始预防。
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