Changes in the cardiovascular system during pregnancy in women with secondary atrial septal defect.
BACKGROUND
The secundum atrial septal defect (ASD II) is, after bicuspid aortic valve, the second most frequent congenital heart disease. In the majority of females with ASD II the course of pregnancy is uncomplicated, however, pregnancy-related cardiovascular changes may affect hemodynamic parameters of the defect.


OBJECTIVE
To assess cardiovascular changes in pregnant females with ASD II.


METHODS
The study group consisted of 54 pregnant females with ASD II and 30 control healthy pregnant women. NYHA class, standard ECG, 24-hour ambulatory ECG monitoring and echocardiography were analysed in the second and third trimester of pregnancy as well as during puerperium.


CONCLUSIONS
(1) Due to the relatively small sample of population studied and limitations of the usage of NYHA classification in pregnant women, the relationship between ASD II and the development of heart failure during pregnancy could not be definitely proved. (2) An increase in the right ventricular and right atrial enlargement was significantly greater in pregnant women with ASD II compared with healthy pregnant females. Also indirect parameters of the right ventricular strain (paradoxical systolic movement of the interventricular septum or tricuspid regurgitation) were more frequent in patients with ASD II rather than in controls. These alterations were accompanied by a significant decrease in the mean value of the Qp/Qs index which may suggest pregnancy-related favourable changes in the hemodynamic consequences of the defect - a decrease in the left-to-right shunt. (3) Paroxysmal supraventricular tachycardia was the most frequent cardiac arrhythmia in pregnant women with ASD II.
Piesiewicz
Wojciech
W
Department of Internal Diseases and Cardiology, M. Madurowicz District Hospital, Łódź, Poland.
Goch
Aleksander
A
Binikowski
Zbigniew
Z
Faflik
Urszula
U
Krasomski
Grzegorz
G
Goch
Jan Henryk
JH
D000293:Adolescent; D000328:Adult; D006332:Cardiomegaly / Q000503:physiopathology; D002319:Cardiovascular System / Q000503:physiopathology*; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology*; D013614:Tachycardia, Paroxysmal / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000503:physiopathology