Cardiac Scan in Pregnancy

Introduction

A cardiac scan during pregnancy is a crucial diagnostic tool used to assess the heart health of both the mother and the fetus. Pregnancy imposes significant physiological changes on the cardiovascular system, increasing the workload on the heart. If a pregnant woman has pre-existing heart conditions or develops symptoms such as shortness of breath, chest pain, or irregular heartbeats, a cardiac evaluation may be necessary.

Types of Cardiac Scans Used in Pregnancy

1. Echocardiography (Echo)

• This is the preferred imaging technique during pregnancy because it is safe and non-invasive.
• Uses ultrasound waves to create real-time images of the heart’s structure and function.
• Useful for detecting congenital heart disease, valvular disease, and cardiomyopathies.

2. Fetal Echocardiography

• Conducted to assess the baby’s heart development.
• Performed between 18–24 weeks of gestation.
• Helps diagnose congenital heart defects early.

3. Magnetic Resonance Imaging (Cardiac MRI)

• Usually reserved for specific cases where detailed imaging is necessary.
• Does not use ionizing radiation, making it safe in pregnancy.
• Used to identify complex congenital or structural cardiac abnormalities.

4. Electrocardiogram (ECG or EKG)

• Records the electrical activity of the maternal heart.
• Helps diagnose arrhythmias and electrical conduction disorders.

5. Computed Tomography (CT) and Nuclear Imaging

• Generally avoided in pregnancy due to radiation exposure risks unless absolutely necessary.
• May be considered in life-threatening conditions where benefits outweigh risks.

Why is a Cardiac Scan Necessary During Pregnancy?

• Pre-existing heart disease (e.g., congenital heart defects, hypertension, arrhythmias).
• Symptoms of heart problems occurring during pregnancy.
• Monitoring of high-risk pregnancies (e.g., preeclampsia, gestational hypertension).
• Evaluation of fetal heart conditions.

Safety Considerations

• Ultrasound-based techniques (echocardiography, fetal echocardiography) are safe during pregnancy.
• MRI is safe but should only be performed when necessary.
• CT and nuclear imaging should be avoided due to radiation risks.
• Always consult a cardiologist and obstetrician before undergoing any imaging procedures.

Conclusion

Cardiac scans in pregnancy play a pivotal role in diagnosing and managing heart conditions in both the mother and the baby. Echocardiography remains the safest and most commonly used technique, while MRI is considered when detailed structural assessment is necessary. Any cardiac evaluation during pregnancy should be performed under medical guidance to ensure the safety of both the mother and the fetus.

Source recommendations

1. American Heart Association Guidelines on Cardiovascular Care in Pregnancy

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000772
2. https://www.heart.org/en/news/2023/02/13/to-improve-maternal-health-report-says-to-start-before-pregnancy
3. https://newsroom.heart.org/news/aha-statement-pregnant-women-with-cvd-need-specialized-care-before-during-and-postpartum
4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001121
5. https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf

2. European Society of Cardiology Guidelines on the Management of Cardiovascular Diseases During Pregnancy

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiovascular-Diseases-during-Pregnancy-Management-of
2. https://pubmed.ncbi.nlm.nih.gov/30165544/
3. https://www.escardio.org/static-file/Escardio/Guidelines/publications/PREGN%20Guidelines-Pregnancy-FT.pdf
4. https://pubmed.ncbi.nlm.nih.gov/21873418/
5. https://academic.oup.com/eurheartj/article/39/34/3165/5078465