Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care
Pregnancy is closely associated with an elevated risk of arrhythmias, constituting the predominant cardiovascular complication during this period. Pregnancy may induce the exacerbation of previously controlled arrhythmias and, in some instances, arrhythmias may present for the first time in pregnanc...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/4/1095 |
| _version_ | 1797297909396406272 |
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| author | Elena Conti Nunzio Dario Cascio Patrizia Paluan Giulia Racca Yaroslava Longhitano Gabriele Savioli Manfredi Tesauro Roberto Leo Fabrizio Racca Christian Zanza |
| author_facet | Elena Conti Nunzio Dario Cascio Patrizia Paluan Giulia Racca Yaroslava Longhitano Gabriele Savioli Manfredi Tesauro Roberto Leo Fabrizio Racca Christian Zanza |
| author_sort | Elena Conti |
| collection | DOAJ |
| description | Pregnancy is closely associated with an elevated risk of arrhythmias, constituting the predominant cardiovascular complication during this period. Pregnancy may induce the exacerbation of previously controlled arrhythmias and, in some instances, arrhythmias may present for the first time in pregnancy. The most important proarrhythmic mechanisms during pregnancy are the atrial and ventricular stretching, coupled with increased sympathetic activity. Notably, arrhythmias, particularly those originating in the ventricles, heighten the likelihood of syncope, increasing the potential for sudden cardiac death. The effective management of arrhythmias during the peripartum period requires a comprehensive, multidisciplinary approach from the prepartum to the postpartum period. The administration of antiarrhythmic drugs during pregnancy necessitates meticulous attention to potential alterations in pharmacokinetics attributable to maternal physiological changes, as well as the potential for fetal adverse effects. Electric cardioversion is a safe and effective intervention during pregnancy and should be performed immediately in patients with hemodynamic instability. This review discusses the pathophysiology of arrythmias in pregnancy and their management. |
| first_indexed | 2024-03-07T22:27:11Z |
| format | Article |
| id | doaj.art-f1c80d60fc2748cba04ea28a998530e8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-07T22:27:11Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f1c80d60fc2748cba04ea28a998530e82024-02-23T15:22:16ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-01134109510.3390/jcm13041095Pregnancy Arrhythmias: Management in the Emergency Department and Critical CareElena Conti0Nunzio Dario Cascio1Patrizia Paluan2Giulia Racca3Yaroslava Longhitano4Gabriele Savioli5Manfredi Tesauro6Roberto Leo7Fabrizio Racca8Christian Zanza9Division of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Ordine Mauriziano, 10128 Turin, ItalyDivision of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Ordine Mauriziano, 10128 Turin, ItalyDivision of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Ordine Mauriziano, 10128 Turin, ItalyDivision of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Ordine Mauriziano, 10128 Turin, ItalyDepartment of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USAEmergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, ItalyGeriatric Medicine Residency Program, University of Rome “Tor Vergata”, 00133 Rome, ItalyDepartment of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, ItalyDivision of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Ordine Mauriziano, 10128 Turin, ItalyGeriatric Medicine Residency Program, University of Rome “Tor Vergata”, 00133 Rome, ItalyPregnancy is closely associated with an elevated risk of arrhythmias, constituting the predominant cardiovascular complication during this period. Pregnancy may induce the exacerbation of previously controlled arrhythmias and, in some instances, arrhythmias may present for the first time in pregnancy. The most important proarrhythmic mechanisms during pregnancy are the atrial and ventricular stretching, coupled with increased sympathetic activity. Notably, arrhythmias, particularly those originating in the ventricles, heighten the likelihood of syncope, increasing the potential for sudden cardiac death. The effective management of arrhythmias during the peripartum period requires a comprehensive, multidisciplinary approach from the prepartum to the postpartum period. The administration of antiarrhythmic drugs during pregnancy necessitates meticulous attention to potential alterations in pharmacokinetics attributable to maternal physiological changes, as well as the potential for fetal adverse effects. Electric cardioversion is a safe and effective intervention during pregnancy and should be performed immediately in patients with hemodynamic instability. This review discusses the pathophysiology of arrythmias in pregnancy and their management.https://www.mdpi.com/2077-0383/13/4/1095pregnancyarrhythmiasstructural heart disease |
| spellingShingle | Elena Conti Nunzio Dario Cascio Patrizia Paluan Giulia Racca Yaroslava Longhitano Gabriele Savioli Manfredi Tesauro Roberto Leo Fabrizio Racca Christian Zanza Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care Journal of Clinical Medicine pregnancy arrhythmias structural heart disease |
| title | Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care |
| title_full | Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care |
| title_fullStr | Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care |
| title_full_unstemmed | Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care |
| title_short | Pregnancy Arrhythmias: Management in the Emergency Department and Critical Care |
| title_sort | pregnancy arrhythmias management in the emergency department and critical care |
| topic | pregnancy arrhythmias structural heart disease |
| url | https://www.mdpi.com/2077-0383/13/4/1095 |
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