title: Shortness of Breath During Pregnancy: Could a Cardiac Factor Be Involved?
abstract: BACKGROUND
  Shortness of breath (SOB) is common among healthy women with normal pregnancies. However, when no overt cardiac or extra cardiac etiology is found, a subtle cardiac source must be excluded.
  
  
  OBJECTIVE
  Pregnancy may induce or unmask myocardial dysfunction that may cause SOB.
  
  
  METHODS
  Healthy pregnant women with significant SOB were recruited for this study. We performed a comprehensive echocardiographic assessment including tissue Doppler imaging (TDI) and 2- dimensional strain imaging (2DS). The echocardiographic data obtained were compared with that of a control group of pregnant women without SOB.
  
  
  RESULTS
  Thirty pregnant women with SOB were enrolled in the study (age, 31.8 ± 4.9 years, and gestation, 38.2 ± 2.8 weeks) for whom no overt etiology for SOB was detected. Patients with SOB compared with controls had thicker hearts (septum: 10.1 ± 1.1 vs 8.9 ± 0.9 mm; P < 0.001; posterior wall: 9.4 ± 1.1 vs 8.9 ± 0.9 mm; P < 0.01), shorter E-wave deceleration time (158.0 ± 50.1 vs 187.1 ± 37.6 msec; P = 0.01), and higher pulmonary artery pressure (26.8 ± 6.2 vs 19.0 ± 6.5 mm Hg, P < 0.01). Women with SOB tended to have a lower S' velocity TDI (P = 0.05) and a trend toward increased torsion on 2DS (P = 0.09).
  
  
  CONCLUSIONS
  Significant SOB during otherwise normal pregnancy is associated with significant echocardiographic findings that may suggest a subtle cardiac involvement. Further investigation is necessary to verify such an association, which may have therapeutic implications for treating SOB of pregnancy.
authors.affiliation: Department of Cardiology, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Sorel
authors.initials: S
authors.lastname: Goland
authors.affiliation: Department of Obstetrics, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Perelman
authors.affiliation: Department of Obstetrics, Hillel Yaffe Medical Center, Hadera, Israel, Affiliated With the Technion School of Medicine, Haifa, Israel.
authors.forename: Nardin
authors.initials: N
authors.lastname: Asalih
authors.affiliation: Department of Cardiology, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Sara
authors.initials: S
authors.lastname: Shimoni
authors.affiliation: Department of Obstetrics, Hillel Yaffe Medical Center, Hadera, Israel, Affiliated With the Technion School of Medicine, Haifa, Israel.
authors.forename: Osnat
authors.initials: O
authors.lastname: Walfish
authors.affiliation: Department of Obstetrics, Hillel Yaffe Medical Center, Hadera, Israel, Affiliated With the Technion School of Medicine, Haifa, Israel.
authors.forename: Mordechai
authors.initials: M
authors.lastname: Hallak
authors.affiliation: Department of Obstetrics, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Zion
authors.initials: Z
authors.lastname: Hagay
authors.affiliation: Department of Cardiology, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.affiliation: Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel, Affiliated With the Technion School of Medicine, Haifa, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Shotan
authors.affiliation: Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel, Affiliated With the Technion School of Medicine, Haifa, Israel.
authors.forename: David S
authors.initials: DS
authors.lastname: Blondheim
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003971:Diastole; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007557:Israel; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left