Management of Parturient Patients with Cardiac Critical Diseases in ICU

Abstract

SUMMARY T he cardiovascular system undergoes significant structural and hemodynamic changes during the course of pregnancy. There are major increases in cardiac output and a decrease in maternal systemic vascular resistance; the renin-angiotensin aldosterone system is significantly activated; and the heart and vasculature undergo remodeling. Understanding the normal cardiovascular changes in pregnancy is essential to care for patients with cardiovascular disease and predict possible cardiac complications. Effective management of congenital heart lesions is based on the treatment of symptoms. Acute myocardial infarction poses a significant risk of maternal mortality and requires prompt treatment with heparin, beta-blockers and nitrates. Peripartum cardiomyopathy is associated with significant maternal mortality and morbidity. Acute pulmonary edema (APE) occurred more frequently antepartum and hypertension was the most common etiology. This severe disease associated with high morbidity and mortality for mother and fetus. Fluid overload seems to have importance in triggering the APE; it necessarily needs admission in ICU and possibility of intubation and mechanically ventilation. Medical cardiovascular complications including myocardial infarction, cardiac arrest, arrhythmia, heart failure, and stroke as