Aditya Upadhyayula, B. S. Preetham, Aswin kumar Mudunuru, Farheen Fatima, Bhavya Reddy, P. S. S. Sri, M. Srinivas
Bipedalism in humans demanded robust postural control systems to maintain balance and equilibrium during variety of volitional activities. Adaptive learning is a key characteristic of these control systems. Postural control and balance are associated with autonomic changes trying to maintain cardiovascular homeostasis during postural imbalances, which are specifically important in conditions like flat foot. Yoga training could help such cases to achieve better postural balance and autonomic state. Young adolescent girls with flat foot were studied in comparison to normal girls and flat foot boys. Sixteen girls and 11 boys with flat foot were subjected to posturography on Wii Balance Board connected wirelessly to PowerLab 15T. Wireless heart rate belt was used to acquire RR intervals. Vrikshasana was chosen as the suitable asana for 4-week training. Displacement of center of pressure (COP) and heart rate variability was analyzed using LabChart pro software before and after yoga training. COP displacement in flat foot subjects is away from the center during erect stance and sway toward sides. Flat foot girls showed significant greater displacements and lesser correction after yoga compared to flat foot boys (P < 0.05). Flat foot girls also showed lesser recovery in LF% and RMSSD after 4-week yoga training. Studying the autonomic changes during voluntary postural imbalance on balance board provide real-time picture of internal state in flat foot individuals. The sympathetic dominance would account for preparedness and adaptation in postural control systems. This state improved with yoga training toward better cardiac vagal tone.
{"title":"Objective Assessment of Cardiopostural Control and its Improvement after Yoga Training using Wii Balance Board and Heart Rate Variability in Young Girls with Flat Foot","authors":"Aditya Upadhyayula, B. S. Preetham, Aswin kumar Mudunuru, Farheen Fatima, Bhavya Reddy, P. S. S. Sri, M. Srinivas","doi":"10.25259/mm_ijcdw_436","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_436","url":null,"abstract":"\u0000\u0000Bipedalism in humans demanded robust postural control systems to maintain balance and equilibrium during variety of volitional activities. Adaptive learning is a key characteristic of these control systems. Postural control and balance are associated with autonomic changes trying to maintain cardiovascular homeostasis during postural imbalances, which are specifically important in conditions like flat foot. Yoga training could help such cases to achieve better postural balance and autonomic state. Young adolescent girls with flat foot were studied in comparison to normal girls and flat foot boys.\u0000\u0000\u0000\u0000Sixteen girls and 11 boys with flat foot were subjected to posturography on Wii Balance Board connected wirelessly to PowerLab 15T. Wireless heart rate belt was used to acquire RR intervals. Vrikshasana was chosen as the suitable asana for 4-week training. Displacement of center of pressure (COP) and heart rate variability was analyzed using LabChart pro software before and after yoga training.\u0000\u0000\u0000\u0000COP displacement in flat foot subjects is away from the center during erect stance and sway toward sides. Flat foot girls showed significant greater displacements and lesser correction after yoga compared to flat foot boys (P < 0.05). Flat foot girls also showed lesser recovery in LF% and RMSSD after 4-week yoga training.\u0000\u0000\u0000\u0000Studying the autonomic changes during voluntary postural imbalance on balance board provide real-time picture of internal state in flat foot individuals. The sympathetic dominance would account for preparedness and adaptation in postural control systems. This state improved with yoga training toward better cardiac vagal tone.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75068541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood pressure recording from the peripheral artery is subject to variations. While blood pressure is said to a modifiable risk factor for many cardiovascular and neurological diseases, the diagnosis of hypertension using Sphygmomanometry must be complemented with other tests to find central blood pressures. A newer, non-invasive method to indirectly record the aortic pressures is required. Aim of the study is to record surface aortic pressure waves (SAP) from aortic area of auscultation during breath holding and to compare the wave characteristics in hypertensive and normotensive women at rest and after mild exercise. 128 women were recruited in the study. Piezoelectric sensor placed in the aortic area was used for getting the SAP waves during breath holding for 30 seconds. ECG was taken to show temporal association of these waves to R waves. Mean arterial pressures from arm (map-a) and from SAP waves (map-s) were calculated. Powerlab 8/35 and Labchart Pro software by AD Instruments were used in the study. R waves were followed by the SAP waves by about 31±2.2 ms at rest and 11±2.4 ms after mild exercise in all subjects. In hypertensive women, the map-s values were significantly (p < 0.05) lower in magnitude than in normotensive women both at rest and after exercise. There was no significant correlation between the map-a and map-s in any of the groups at rest or after exercise. This new method, with some refinement could prove as a better alternative to blood pressure recording.
{"title":"Surface Recording of Aortic Pressure Wave from Aortic Area of Auscultation in Women with Hypertension: A New Idea to Indirectly Monitor Aortic Pressure","authors":"Telkapalli Sarada Padmambika, Apurva Deshpande, Aswin kumar Mudunuru, Farheen Fatima, Sandadi Snigdha Reddy","doi":"10.25259/mm_ijcdw_418","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_418","url":null,"abstract":"\u0000\u0000Blood pressure recording from the peripheral artery is subject to variations. While blood pressure is said to a modifiable risk factor for many cardiovascular and neurological diseases, the diagnosis of hypertension using Sphygmomanometry must be complemented with other tests to find central blood pressures. A newer, non-invasive method to indirectly record the aortic pressures is required. Aim of the study is to record surface aortic pressure waves (SAP) from aortic area of auscultation during breath holding and to compare the wave characteristics in hypertensive and normotensive women at rest and after mild exercise.\u0000\u0000\u0000\u0000128 women were recruited in the study. Piezoelectric sensor placed in the aortic area was used for getting the SAP waves during breath holding for 30 seconds. ECG was taken to show temporal association of these waves to R waves. Mean arterial pressures from arm (map-a) and from SAP waves (map-s) were calculated. Powerlab 8/35 and Labchart Pro software by AD Instruments were used in the study.\u0000\u0000\u0000\u0000R waves were followed by the SAP waves by about 31±2.2 ms at rest and 11±2.4 ms after mild exercise in all subjects. In hypertensive women, the map-s values were significantly (p < 0.05) lower in magnitude than in normotensive women both at rest and after exercise. There was no significant correlation between the map-a and map-s in any of the groups at rest or after exercise.\u0000\u0000\u0000\u0000This new method, with some refinement could prove as a better alternative to blood pressure recording.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84365247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Leader in Pediatric Cardiology: Preface","authors":"M. Jyotsna","doi":"10.25259/mm_ijcdw_481","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_481","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76014419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertension is one of the major contributing risk factor of cardiovascular diseases. Despite enormous advances in the preventive cardiology, hypertension remains the leading cause of death and disability in women. The article aims to focus on the gender specific differences in hypertension, and existing gaps in the current understanding of high blood pressure (BP) in women. Apart from epidemiological differences, hypertension in men and women has distinct pathophysiological mechanisms, impact on cardiovascular system, awareness and control. Prevalence of hypertension is higher in men than women till menopause; following this the prevalence rises steeply in women, and exceeds that of men above 75 years of age. Women with their estrogenic environment are relatively protected from high BP as their hormonal/chromosomal profile govern expression of alternate renin angiotensin axis (RAS) pathway and anti-inflammatory, vasodilatory, anti-proliferative immune cells whereas in males, classical RAS driven inflammatory, pro-hypertensive and proliferative milieu confers higher risk of hypertension. Thus, immunotherapy can have a potential therapeutic role in the treatment of hypertension in future. Cardiovascular consequences of high BP are worse in women than men in majority of trials. Women are now getting more aware of hypertension but the control of BP still remains poorer than men, especially in older age group. There are some noteworthy pharmacokinetic and pharmacogenomics gender differences in response to various antihypertensive drugs, which can be taken into consideration while choosing a particular class of drugs in female population. Standard treatment guidelines recommend same BP targets and management strategies in both the genders, but the trials so far have not been designed in a way to draw women specific conclusions on optimal cut-offs for diagnosis and treatment of BP due to under representation of women in majority of trials. More women centered analysis in future hypertension research projects can provide better scientific insights in various clinical aspects of hypertension.
{"title":"Hypertension in Women: The Current Understanding and Future Goals","authors":"P. Goyal, S. Chhabra, M. Jyotsna","doi":"10.25259/mm_ijcdw_476","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_476","url":null,"abstract":"Hypertension is one of the major contributing risk factor of cardiovascular diseases. Despite enormous advances in the preventive cardiology, hypertension remains the leading cause of death and disability in women. The article aims to focus on the gender specific differences in hypertension, and existing gaps in the current understanding of high blood pressure (BP) in women. Apart from epidemiological differences, hypertension in men and women has distinct pathophysiological mechanisms, impact on cardiovascular system, awareness and control. Prevalence of hypertension is higher in men than women till menopause; following this the prevalence rises steeply in women, and exceeds that of men above 75 years of age. Women with their estrogenic environment are relatively protected from high BP as their hormonal/chromosomal profile govern expression of alternate renin angiotensin axis (RAS) pathway and anti-inflammatory, vasodilatory, anti-proliferative immune cells whereas in males, classical RAS driven inflammatory, pro-hypertensive and proliferative milieu confers higher risk of hypertension. Thus, immunotherapy can have a potential therapeutic role in the treatment of hypertension in future. Cardiovascular consequences of high BP are worse in women than men in majority of trials. Women are now getting more aware of hypertension but the control of BP still remains poorer than men, especially in older age group. There are some noteworthy pharmacokinetic and pharmacogenomics gender differences in response to various antihypertensive drugs, which can be taken into consideration while choosing a particular class of drugs in female population. Standard treatment guidelines recommend same BP targets and management strategies in both the genders, but the trials so far have not been designed in a way to draw women specific conclusions on optimal cut-offs for diagnosis and treatment of BP due to under representation of women in majority of trials. More women centered analysis in future hypertension research projects can provide better scientific insights in various clinical aspects of hypertension.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84614439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Simple Tools to Detect Diastolic Dysfunction","authors":"M. Govindarajan","doi":"10.25259/mm_ijcdw_478","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_478","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81326029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 58-year-old woman presented with dyspnea on exertion and bilateral pedal edema for 3 months. She was found to have severe pulmonary hypertension (PH) with the right ventricular failure. The detailed evaluation did not reveal any secondary cause for PH (cardiac disease, pulmonary embolism, interstitial or other lung disease, collagen vascular disease, portal hypertension, or chronic liver disease). Meanwhile, her workup revealed multiple myeloma. Abdominal fat pad biopsy was performed because PH as an isolated manifestation of cardiac amyloidosis was previously reported. Thus, she was diagnosed to have systemic amyloidosis secondary to myeloma. PH was attributed to cardiac amyloidosis. We present a patient with PH and amyloidosis secondary to multiple myeloma. PH and primary systemic amyloidosis without cardiac or parenchymal lung involvement are extremely rare with only a few cases reported in the past.
{"title":"Cardiac Amyloidosis Presenting as Isolated Severe Pulmonary Artery Hypertension","authors":"M. Abdulla","doi":"10.25259/mm_ijcdw_461","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_461","url":null,"abstract":"A 58-year-old woman presented with dyspnea on exertion and bilateral pedal edema for 3 months. She was found to have severe pulmonary hypertension (PH) with the right ventricular failure. The detailed evaluation did not reveal any secondary cause for PH (cardiac disease, pulmonary embolism, interstitial or other lung disease, collagen vascular disease, portal hypertension, or chronic liver disease). Meanwhile, her workup revealed multiple myeloma. Abdominal fat pad biopsy was performed because PH as an isolated manifestation of cardiac amyloidosis was previously reported. Thus, she was diagnosed to have systemic amyloidosis secondary to myeloma. PH was attributed to cardiac amyloidosis. We present a patient with PH and amyloidosis secondary to multiple myeloma. PH and primary systemic amyloidosis without cardiac or parenchymal lung involvement are extremely rare with only a few cases reported in the past.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83632552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anand Pasula, K. Karthikeya, S. Patnaik, Madhuri Howdekar
Unilateral absent pulmonary artery (UAPA) is a rare congenital disorder. Most of the patients will be diagnosed in the early childhood because of recurrent respiratory tract infections and hemoptysis, but adult presentation is not uncommon. We report a 47-year-old female who was earlier diagnosed as bronchiectasis with pulmonary artery hypertension but now presented with complaints of typical angina and dyspnea on exertion. During right heart catheterization we failed to enter right pulmonary artery (RPA), and conventional coronary angiogram showed a large left atrial branch of left circumflex giving collateral blood supply to the right lung. Computed tomography angiogram showed absent RPA. We report this case not only because the patient was misdiagnosed but also because of rarity of coronary collaterals in UAPA patients and unusual bilateral bronchiectasis. According to reported literature, ours is the 28th case of this nature.
{"title":"Rare Cause of Secondary Pulmonary Arterial Hypertension","authors":"Anand Pasula, K. Karthikeya, S. Patnaik, Madhuri Howdekar","doi":"10.1055/s-0041-1740355","DOIUrl":"https://doi.org/10.1055/s-0041-1740355","url":null,"abstract":"Unilateral absent pulmonary artery (UAPA) is a rare congenital disorder. Most of the patients will be diagnosed in the early childhood because of recurrent respiratory tract infections and hemoptysis, but adult presentation is not uncommon. We report a 47-year-old female who was earlier diagnosed as bronchiectasis with pulmonary artery hypertension but now presented with complaints of typical angina and dyspnea on exertion. During right heart catheterization we failed to enter right pulmonary artery (RPA), and conventional coronary angiogram showed a large left atrial branch of left circumflex giving collateral blood supply to the right lung. Computed tomography angiogram showed absent RPA. We report this case not only because the patient was misdiagnosed but also because of rarity of coronary collaterals in UAPA patients and unusual bilateral bronchiectasis. According to reported literature, ours is the 28th case of this nature.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82733760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Jyotsna, Srikiran Jakkula, Narayanam Srikanth, Achukatla Kumar
This study was done to evaluate the lung ultrasound findings such as Kerley A and Kerley B lines and the correlation between them with duration of hospital stay, where patients with Kerley A lines had longer duration of hospital stay even though it was statistically insignificant. N-terminal pro-brain natriuretic peptide levels were higher in female patients when compared with males in acute decompensated heart failure.
{"title":"Bedside Lung Ultrasound in Patients with Acute Decompensated Heart Failure—An Observational Study","authors":"M. Jyotsna, Srikiran Jakkula, Narayanam Srikanth, Achukatla Kumar","doi":"10.1055/s-0042-1744278","DOIUrl":"https://doi.org/10.1055/s-0042-1744278","url":null,"abstract":"This study was done to evaluate the lung ultrasound findings such as Kerley A and Kerley B lines and the correlation between them with duration of hospital stay, where patients with Kerley A lines had longer duration of hospital stay even though it was statistically insignificant. N-terminal pro-brain natriuretic peptide levels were higher in female patients when compared with males in acute decompensated heart failure.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83700422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Myocardial bridge (MB) is a portion of an epicardial coronary artery that takes an intramuscular course. The systolic compression of MB often gets carried over to early and mid-diastole, compromising coronary blood flow. In clinical practice, we encounter patients with angina, non-invasive evidence of ischemia, and a MB as the only relevant finding on angiography. In view of studies in support of decreased coronary flow reserve in MB, we assessed the physiological significance of MB by fractional flow reserve (FFR). Methods and Results We enrolled eight patients with chronic stable angina and positive noninvasive stress test, who had no significant CAD, and with evidence of MB in the left anterior descending artery. Mean age of population was 57.14 ± 6.25 years. Two (25%) were females and six (75%) were males. Four (50%) were smokers, five (62.5%) were diabetics, and two (25%) were hypertensives. Mean length of MB is 19.4 ± 5.04 mm. All underwent physiological assessment by FFR and the baseline, post nitroglycerin (NTG), and post adenosine readings were noted. Mean pre-NTG value, post-NTG, and post-adenosine were 0.974 ± 0.022, 0.96 ± 0.03, and 0.88 ± 0.042 (≤0.80 hemodynamically significant) respectively. Paired t-test showed significant reduction in FFR after NTG (p = 0.0452) and post-adenosine (p = 0.011) but all eight patients did not get significant FFR. Conclusion MB was found to be physiologically insignificant in our group of patients. But a statistical significant reduction of FFR in MB, post NTG and post adenosine, does impress on the fact that, an extensive study over a longer period of course, could throw light on this unsettled area of physiological significance and optimal therapeutic approach.
{"title":"Physiological Significance of Myocardial Bridging by Fractional Flow Reserve—An Observational Study","authors":"A. Panda, K. Jain, Harish Reddy M.S","doi":"10.1055/s-0042-1744276","DOIUrl":"https://doi.org/10.1055/s-0042-1744276","url":null,"abstract":"Myocardial bridge (MB) is a portion of an epicardial coronary artery that takes an intramuscular course. The systolic compression of MB often gets carried over to early and mid-diastole, compromising coronary blood flow. In clinical practice, we encounter patients with angina, non-invasive evidence of ischemia, and a MB as the only relevant finding on angiography. In view of studies in support of decreased coronary flow reserve in MB, we assessed the physiological significance of MB by fractional flow reserve (FFR).\u0000 Methods and Results We enrolled eight patients with chronic stable angina and positive noninvasive stress test, who had no significant CAD, and with evidence of MB in the left anterior descending artery. Mean age of population was 57.14 ± 6.25 years. Two (25%) were females and six (75%) were males. Four (50%) were smokers, five (62.5%) were diabetics, and two (25%) were hypertensives. Mean length of MB is 19.4 ± 5.04 mm. All underwent physiological assessment by FFR and the baseline, post nitroglycerin (NTG), and post adenosine readings were noted. Mean pre-NTG value, post-NTG, and post-adenosine were 0.974 ± 0.022, 0.96 ± 0.03, and 0.88 ± 0.042 (≤0.80 hemodynamically significant) respectively. Paired t-test showed significant reduction in FFR after NTG (p = 0.0452) and post-adenosine (p = 0.011) but all eight patients did not get significant FFR.\u0000 Conclusion MB was found to be physiologically insignificant in our group of patients. But a statistical significant reduction of FFR in MB, post NTG and post adenosine, does impress on the fact that, an extensive study over a longer period of course, could throw light on this unsettled area of physiological significance and optimal therapeutic approach.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"336 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91383033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kumari Gethu, Nivetida Jha, S. Rengaraj, Veena Pampapati, H. Munuswamy, A. Pillai
Cardiovascular disease in pregnancy contributes to a significant proportion of death worldwide. Though pregnancy-associated myocardial infarction and aortic dissection are the common causes of adverse cardiac events in developed countries, rheumatic heart diseases continue to be the important reason for cardiovascular morbidity and mortality in developing countries. The risk of adverse cardiac outcome is dependent on the type and severity of valvular abnormality, functional status, left ventricular function, and pulmonary arterial pressure. Managing a pregnant woman with a mechanical heart valve prosthesis is challenging because of the difficulty in achieving optimal anticoagulation in the presence of hypercoagulability. Mitral valve thrombus is a life-threatening event and women can present with acute heart failure or thromboembolic events. We report successful management of a 26-year-old primigravida with rheumatic heart disease diagnosed to have huge thrombus on mechanical prosthetic mitral valve presented with acute heart failure at 36 weeks. She received multidisciplinary care and underwent concurrent cesarean section followed by thrombectomy under cardiopulmonary bypass. She had a good recovery following surgery and the complexity surrounds the management merit the presentation with a review of management strategies for a women with mechanical prosthetic heart valve in pregnancy.
{"title":"Mechanical Prosthetic Valve Thrombus in a Term Pregnant Woman Presenting as Acute Heart Failure: Case Report and Review of Literature","authors":"Kumari Gethu, Nivetida Jha, S. Rengaraj, Veena Pampapati, H. Munuswamy, A. Pillai","doi":"10.1055/s-0041-1740354","DOIUrl":"https://doi.org/10.1055/s-0041-1740354","url":null,"abstract":"Cardiovascular disease in pregnancy contributes to a significant proportion of death worldwide. Though pregnancy-associated myocardial infarction and aortic dissection are the common causes of adverse cardiac events in developed countries, rheumatic heart diseases continue to be the important reason for cardiovascular morbidity and mortality in developing countries. The risk of adverse cardiac outcome is dependent on the type and severity of valvular abnormality, functional status, left ventricular function, and pulmonary arterial pressure. Managing a pregnant woman with a mechanical heart valve prosthesis is challenging because of the difficulty in achieving optimal anticoagulation in the presence of hypercoagulability. Mitral valve thrombus is a life-threatening event and women can present with acute heart failure or thromboembolic events. We report successful management of a 26-year-old primigravida with rheumatic heart disease diagnosed to have huge thrombus on mechanical prosthetic mitral valve presented with acute heart failure at 36 weeks. She received multidisciplinary care and underwent concurrent cesarean section followed by thrombectomy under cardiopulmonary bypass. She had a good recovery following surgery and the complexity surrounds the management merit the presentation with a review of management strategies for a women with mechanical prosthetic heart valve in pregnancy.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83699892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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