CVD Case Series: Screening and Risk Reduction

Abstract

Undetected cardiovascular disease is one of the leading causes of complications during pregnancy in the United States. Maternal mortality reviews indicate that lack of suspicion and delays in diagnosis are the primary drivers of CVD-related mortality. Purpose of this study is to examine the effect of implementing the CVD (Cardiovascular Disease) Risk Assessment tool developed by the California Maternal Quality Care Collaborative (CMQCC) team in 2018. Eligibility of patients in the case series was determined through CVD risk screen score of 4 or higher using a standardized stool adopted from the CMQCC. The patient was scored at the point of hospital entry. Factors used in scoring included symptoms, vitals and risk factors. Patients who scored positive were sent for further work up. This included in-depth analysis of other significant clinical factors influencing patient presentation and subsequent management. The CV patient cases presented in this case series illustrate the benefits of early identification and implementation of standardized CVD risk assessment. There are significant benefits in early use of the CV screening tool contributing to mortality risk reduction including continued close antenatal surveillance, postpartum follow-up, and continued collaborative multidisciplinary care. Patients with risk factors underwent continued surveillance and received appropriate specialized follow-up that allowed for improved maternal outcomes. Proper implementation of CVD risk assessment tool for patients who are at-risk of development of CVD in pregnancy can effectively reduce adverse maternal outcomes related to cardiac disease.