Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast Episode 172: A Pregnant Patient with Congenital Heart Disease
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May 1, 2020 AI Snips
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Confirm Repair Details And Functional Status
- Do review the patient's congenital lesion, prior repair details, and current echo before induction.
- Ask targeted history about pre-pregnancy and trimester symptoms to gauge functional reserve.
Use Echo And BNP To Differentiate Symptoms
- Order an echo and BNP to distinguish heart failure from normal pregnancy symptoms.
- Use BNP baseline and trends because a markedly elevated BNP suggests real cardiac dysfunction.
Labor Is A Series Of Autotransfusions
- Labor causes repeated 300 mL autotransfusions with each contraction and a large bolus at delivery.
- These volume shifts stress both right and left heart and can unmask RV dysfunction.