Role of Echocardiography in the Management of Cardiac Disease in Women

Abstract

The widespread use of echocardiography has contributed to the early recognition of several distinct cardiac diseases in women. During pregnancy, safe monitoring of the disease process, as well as a better understanding of hemodynamics, is possible. During the use of potentially cardiotoxic drugs for breast cancer chemotherapy, echocardiographic patient monitoring is vital. Compared to men, the addition of an imaging modality to routine electrocardiogram monitoring during stress testing is more informative for diagnosing coronary disease in women. This review briefly discusses the role of echocardiography in the management of several women-specific cardiac diseases where echocardiography plays a pivotal role in disease management.

Algorithm of echocardiography in pregnant women

“…Дилатация восходящей аорты выявляется примерно у 50% беременных с бикуспидальным аортальным клапаном. В этих случаях особо внимательно контролируют размеры аорты при каждом ЭхоКГ обследовании [21]. Если определен диаметр восходящей аорты ≥50 мм (27,5 мм/м 2 ) у женщины, планирующей беременность, то независимо от наличия симптомов нужно с кардиохирургами обсуждать возможность оперативного вмешательства до беременности, так как степень дилатации может увеличиваться и есть риск диссекции.…”

“…и через 6 мес. после родов [21]. Нарастание размера во время беременности считают фактором риска диссекции аорты.…”

Echocardiography in Pregnancy: Part 1

“…The main pathophysiologic mechanisms in pregnant women with CHD include volume overload, leftto-right shunts, pressure overload, and cyanotic right-to-left shunts [4]. Table 1 summarizes a list of CHD with increasing maternal risk.…”

“…In general, saline contrast should be avoided during pregnancy to minimize any possible embolic risk [12]. Closure of an ASD is not indicated unless the mother is deteriorating; however, it can be performed during pregnancy if needed using transesophageal or intracardiac echo guidance [4].…”

“…On Doppler, a high velocity jet is seen from LV to RV with normal chamber dimensions and function [12]. These defects are well tolerated during pregnancy [4,13]. However, in the presence of a large defect, left ventricular volume overload and RV hypertrophy occur.…”