About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Cardiovascular Changes in Pregnancy
Introduction
Pregnancy induces significant changes in the cardiovascular system to support the developing fetus. These physiological adaptations are necessary to accommodate increased metabolic demands and ensure adequate blood flow to the placenta.
Key Cardiovascular Changes
1. Increase in Blood Volume and Cardiac Output
- Blood volume increases by 30–50% to supply oxygen and nutrients to the fetus.
- Cardiac output (the amount of blood the heart pumps per minute) increases by 30–50%, mainly due to increased stroke volume and heart rate.
- The maximum rise in cardiac output occurs around 24–28 weeks gestation.
2. Heart Rate Increase
- Maternal heart rate rises by 10–15 beats per minute to compensate for increased circulatory demands.
- This ensures effective oxygen delivery to the placenta and maternal organs.
3. Blood Pressure Changes
- First and second trimesters: Blood pressure may decrease due to systemic vascular resistance reduction.
- Third trimester: Blood pressure gradually normalizes but should not exceed pre-pregnancy values significantly.
- Supine Hypotensive Syndrome: Lying flat can compress the inferior vena cava, reducing venous return and decreasing blood pressure.
4. Vascular Resistance Reduction
- Hormonal changes, particularly the effects of progesterone, cause blood vessels to relax and widen.
- This leads to a decrease in systemic vascular resistance, facilitating increased blood flow to the uterus.
5. Changes in Blood Composition
- Plasma volume expansion leads to physiological anemia of pregnancy, as red blood cell production does not increase proportionally.
- Increased coagulation factors result in a hypercoagulable state, elevating the risk of thrombosis.
Clinical Implications
- Heart Murmurs: Increased blood flow may cause benign systolic murmurs.
- Edema and Varicose Veins: Venous return is affected, increasing the risk of varicose veins and leg swelling.
- Increased Risk of Pre-eclampsia: A pathological increase in blood pressure, proteinuria, and organ damage may occur in some women.
- Cardiac Disease Risk in Pregnancy: Pre-existing heart conditions (e.g., congenital heart disease, cardiomyopathies) require close monitoring.
Conclusion
These cardiovascular adaptations are essential for a healthy pregnancy but can pose risks for women with pre-existing heart conditions. Regular monitoring by healthcare professionals is crucial to ensuring maternal and fetal well-being.
Source recommendations
1. American College of Obstetricians and Gynecologists (ACOG) Guidelines
- https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline
- https://www.guidelinecentral.com/guidelines/ACOG/
- https://www.acog.org/clinical
- https://pubmed.ncbi.nlm.nih.gov/35576364/
- https://www.acog.org/
2. European Society of Cardiology (ESC) Guidelines on the Management of Cardiovascular Diseases during Pregnancy
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiovascular-Diseases-during-Pregnancy-Management-of
- https://pubmed.ncbi.nlm.nih.gov/30165544/
- https://www.escardio.org/static-file/Escardio/Guidelines/publications/PREGN%20Guidelines-Pregnancy-FT.pdf
- https://pubmed.ncbi.nlm.nih.gov/21873418/
- https://academic.oup.com/eurheartj/article/39/34/3165/5078465
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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