Heart failure in pregnancy

Abstract

Decompensated heart failure can present during peripartum period either because of the pre-existing cardiac disease or disease acquired during pregnancy. The clinical signs and the investigations related to heart failure should be interpreted taking into considerations the physiologic changes of pregnancy. The mainstay of therapy in the pregnant patient includes supplemental oxygen and pharmacological therapy, with diuretics, vasodilators, and inotropes. The dug and the doses should be administered in pregnant patients according to the pharmacokinetic and pharmacodynamic changes and the effects on fetus. For refractory cardiogenic shock with decompensated heart failure in pregnant patients, Mechanical circulatory devices should be considered. Shared decision-making and multidisciplinary approach is key to the management of acute decompensated heart failure during pregnancy and peripartum period.