Heart Failure Symptoms in Pregnancy Related to Cardiac Structure and Function by Echocardiography [8B

Abstract

INTRODUCTION: Pregnancy is associated with physiologic changes causing alterations in cardiovascular hemodynamics, sometimes resulting heart failure (HF) symptoms which should be distinguished as physiologic or pathologic. We hypothesized that pregnant women with HF symptoms are more likely to have a difference in cardiac structure and function as determined by transthoracic echocardiogram (TTE). METHODS: 237 pregnant women with no known cardiac history underwent TTE and questionnaires in the 3rd trimester and five months postpartum. HF symptoms were classified using modified Boston criteria (MBS), National Health and Nutrition Examination Survey (NHANES), and New York Heart Association (NYHA). RESULTS: 48 patients (18%) had HF symptoms by MBS, 56 (24%) by NHANES, 148 (62%) had NYHA Class III/IV symptoms, and 24 patients (10%) met all 3 criteria. Self-reported symptoms including lack of energy, early satiety, and palpitations were correlated with higher HF scores on all scales (P CONCLUSION: The 3rd trimester brings subtle changes in cardiac structure and function that may be associated with HF symptoms. While some pregnant women meet HF criteria based on symptoms and have corresponding differences on TTE, it is reassuring that these changes resolve postpartum and likely reflect physiologic changes in pregnancy.