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Pregnancy can mask heart disease. (Watch for Onset of Cough).
HILTON HEAD, S.C. -- The signs and symptoms of a normal pregnancy can mask the presence of cardiac disease, Dr. Carole Warnes cautioned at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.
Especially in high-risk patients with a known congenital heart condition, the onset of a cough or asthma-like symptoms during pregnancy may actually be an indication of an underlying heart problem growing worse, said Dr. Warnes, a cardiologist at the Mayo Clinic.
She managed such a patient who was near death at 32 weeks' gestation when she was flown to the Rochester, Minn., medical center for emergent care due to severe aortic stenosis.
Such presentations aren't rare at the clinic, noted Dr. Kirk Ramin, chair of the division of maternal-fetal medicine at the center.
"I've seen too many patients [with valve problems] treated with inhaled steroids and antibiotics," he said.
And it's not just obstetricians who fail to be proactive enough in managing and counseling patients about heart problems in pregnancy. "It's cardiologists, too," Dr. Warnes said.
The patient with aortic stenosis whom Dr. Warnes saw at Mayo was 30 years old and had a history of a heart murmur since childhood, but that condition was never adequately evaluated in the context of her pregnancy. As a result, her physicians misdiagnosed her symptoms of cough and dyspnea as bronchitis instead of recognizing them as pulmonary edema. She was treated with antibiotics.
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Source: HighBeam Research, Pregnancy can mask heart disease. (Watch for Onset of Cough).