Heart Failure & Pregnancy
This infographic delves into how heart failure (HF) and pregnancy intersect, with a focus on the risks posed by prepregnancy cardiomyopathy and peripartum cardiomyopathy. Women with persistent left ventricular dysfunction (LVEF <50%) before pregnancy are at heightened risk for serious complications, including further LVEF deterioration, maternal death, and adverse fetal outcomes. The guidelines stress the importance of counseling on the risks of cardiovascular deterioration during pregnancy.
The infographic also highlights racial disparities: Black and Hispanic women tend to develop more severe peripartum cardiomyopathy, experience worse disease progression, and face higher inpatient mortality rates compared to their white counterparts.
Key Recommendations
- Contraceptive counseling for women with HF or cardiomyopathy to prevent pregnancy-associated risks.
- Anticoagulation therapy for acute HF with reduced LVEF (<30%) during pregnancy and postpartum, though efficacy remains uncertain.
- Avoidance of ACE inhibitors, ARBs, MRAs, and ivabradine during pregnancy due to their potential for fetal harm.
Risk Factors
- Maternal age over 30 years
- Multiparity
- Pre-existing hypertension or diabetes
- Pre-eclampsia and prolonged tocolysis
- African ancestry
Produced by Dr. Alaa Diab
Reviewed by Dr. Teodora Donisan
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