Insuficiencia cardiaca aguda en el embarazo: diagnóstico y tratamiento

Edison Muñoz-Ortiz; Jairo A. Gándara-Ricardo; Érica Holguín-González; Jesús A. Velázquez-Penagos; Juan P. Flórez-Muñoz; Miguel B. Giraldo-Serna; Yasser I. Arana-Escandón

doi:10.47487/apcyccv.v7i3.644

Authors

Edison Muñoz-Ortiz Clínica de Embarazo y Enfermedad Cardiaca, Unidad Funcional Cardiopulmonar y Vascular Periférico, Hospital San Vicente Fundación. Medellín, Antioquia, Colombia; Sección de Cardiología, Departamento de Medicina Interna, Universidad de Antioquia. Medellín, Antioquia, Colombia. https://orcid.org/0000-0002-5156-7985
Jairo A. Gándara-Ricardo Clínica de Embarazo y Enfermedad Cardiaca, Unidad Funcional Cardiopulmonar y Vascular Periférico, Hospital San Vicente Fundación. Medellín, Antioquia, Colombia; Sección de Cardiología, Departamento de Medicina Interna, Universidad de Antioquia. Medellín, Antioquia, Colombia. https://orcid.org/0000-0003-0757-0033
Érica Holguín-González Clínica de Embarazo y Enfermedad Cardiaca, Departamento de Anestesiología y Reanimación, Hospital San Vicente Fundación. Medellín, Antioquia, Colombia. https://orcid.org/0000-0001-6653-7095
Jesús A. Velázquez-Penagos Clínica de Embarazo y Enfermedad Cardiaca, Unidad Funcional Materno-infantil, Hospital San Vicente Fundación. Medellín, Antioquia, Colombia; Sección de Perinatología y Alto Riesgo Obstétrico, Departamento de Obstetricia y Ginecología, Universidad de Antioquia. Medellín, Antioquia, Colombia. https://orcid.org/0000-0003-4622-327X
Juan P. Flórez-Muñoz Clínica de Embarazo y Enfermedad Cardiaca, Unidad Funcional Cardiopulmonar y Vascular Periférico, Hospital San Vicente Fundación. Medellín, Antioquia, Colombia; Sección de Cardiología, Departamento de Medicina Interna, Universidad de Antioquia. Medellín, Antioquia, Colombia. https://orcid.org/0000-0002-1531-3152
Miguel B. Giraldo-Serna Clínica de Embarazo y Enfermedad Cardiaca, Unidad Funcional Cardiopulmonar y Vascular Periférico, Hospital San Vicente Fundación. Medellín, Antioquia, Colombia; Sección de Cardiología, Departamento de Medicina Interna, Universidad de Antioquia. Medellín, Antioquia, Colombia. https://orcid.org/0000-0002-1762-5520
Yasser I. Arana-Escandón Departamento de Medicina Interna, Universidad de Antioquia. Medellín, Antioquia, Colombia. https://orcid.org/0009-0003-8496-2708

DOI:

https://doi.org/10.47487/apcyccv.v7i3.644

Keywords:

Heart Failure, Pregnancy, Pregnancy Complications, Cardiovascular, Peripartum Cardiomyopathy

Abstract

Heart disease affects approximately 4% of pregnancies and is the leading non-obstetric cause of maternal death during pregnancy in many countries. The physiological hormonal and haemodynamic changes that occur during this period can unmask previously undiagnosed cardiac disease and destabilise pre-existing cardiovascular conditions. Acute heart failure during pregnancy is uncommon; however, it can lead to severe maternal and fetal complications. Although the diagnostic criteria are the same as those used in the general population, diagnosis can be challenging because the cardinal signs and symptoms of heart failure overlap with several symptoms and clinical findings that commonly occur during pregnancy. A comprehensive clinical history therefore remains fundamental to the diagnostic approach, enabling the rational use of complementary investigations and, in many cases, guiding treatment. Management of acute heart failure during pregnancy must be highly individualised and may involve decisions regarding continuation of the pregnancy and the optimal mode of delivery. Care should therefore be led by an experienced multidisciplinary team with expertise in the diagnosis and management of cardiovascular disease during pregnancy, with the aim of achieving the best possible outcomes for both the mother and the fetus.

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