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Cardiovascular Disease in Women and in Pregnancy

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MGH Cardiology Board Review

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Abstract

Cardiovascular disease remains the leading cause of mortality among women. Increasingly, sex differences are being recognized with respect to both traditional and sex-specific risk factors, pathophysiology of disease, clinical presentation, therapeutic approaches, and utilization of guideline-directed therapies. In addition, cardiovascular disease is a leading cause of maternal morbidity and mortality in pregnancy. Several unique considerations are required when treating women with cardiovascular disease both pre-conception and during pregnancy. Further, cardiovascular complications of pregnancy—including development of gestational hypertensive diseases—increase a woman’s risk of future cardiovascular disease and are important risk factors to consider in the care and risk stratification of women.

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Abbreviations

ACEi:

Angiotensin converting enzyme inhibitor

ACS:

Acute coronary syndrome

AF:

Atrial fibrillation

AHA:

American Heart Association

AMI:

Acute myocardial infarction

ARB:

Angiotensin receptor blocker

AS:

Aortic stenosis

AVR:

Aortic valve replacement

BP:

Blood pressure

BMI:

Body-mass index

BMS:

Bare metal stent

CABG:

Coronary artery bypass grafting

CAD:

Coronary artery disease

CAS:

Coronary artery spasm

CRT:

Cardiac Resynchronization Therapy

CO:

Cardiac output

CV:

Cardiovascular

CVD:

Cardiovascular disease

DES:

Drug eluting stent

DOAC:

Direct oral anticoagulant

ESC:

European Society of Cardiology

FMD:

Fibromuscular dysplasia

HDL:

High density lipoprotein

HF:

Heart failure

HFrEF:

Heart failure with reduced ejection fraction

HFpEF:

Heart failure with preserved ejection fraction

HR:

Heart rate

HTN:

Hypertension

ICD:

Implantable cardioverter defibrillators

IHD:

Ischemic heart disease

LBBB:

Left bundle branch block

LDL:

Low density lipoprotein

LMWH:

Low molecular weight heparin

LV:

Left ventricular

LVAD:

Left ventricular assist device

LVEF:

Left ventricular ejection fraction

MACE:

Major adverse cardiovascular event

MCS:

Mechanical circulatory support

MFM:

Maternal fetal medicine

MI:

Myocardial infarction

MINOCA:

Myocardial infarction with nonobstructive coronary arteries

MR:

Mitral regurgitation

MS:

Mitral stenosis

MV:

Mitral valve

NSTEMI:

Non-ST-elevation myocardial infarction

NYHA:

New York Heart Association

OB:

Obstetric

OCP:

Oral contraceptive pill

PAMI:

Pregnancy-associated myocardial infarction

PCI:

Percutaneous coronary intervention

PMI:

Point of maximal impulse

PPCM:

Peripartum cardiomyopathy

PTT:

Partial thromboplastin time

RV:

Right ventricular

SAVR:

Surgical aortic valve replacement

SCAD:

Spontaneous coronary artery dissection

STEMI:

ST-elevation myocardial infarction

STS:

Society of Thoracic Surgeons

SVR:

Systemic vascular resistance

TAVR:

Transcatheter aortic valve replacement

TC:

Total cholesterol

TG:

Triglycerides

UFH:

Unfractionated heparin

US:

United States

VT:

Ventricular tachycardia

VF:

Ventricular fibrillation

VKA:

Vitamin K antagonists

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Acknowledgement

We would like to thank Dr. Lauren Gilstrap for her work on the previous version of this chapter.

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Author notes

  1. Authors Emily S. Lau and Amy A. Sarma contributed equally for this chapter.

    Authors Nandita S. Scott and Malissa J. Wood contributed equally for this chapter.

Authors and Affiliations

  1. Massachusetts General Hospital, Boston, MA, USA

    Emily S. Lau, Amy A. Sarma, Nandita S. Scott & Malissa J. Wood

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  1. Emily S. Lau
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Correspondence to Malissa J. Wood .

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Editors and Affiliations

  1. Cardiology Division, Massachusetts General Hospital, Boston, MA, USA

    Hanna K. Gaggin

  2. Cardiology Division, Massachusetts General Hospital, Boston, MA, USA

    James L. Januzzi Jr.

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Lau, E.S., Sarma, A.A., Scott, N.S., Wood, M.J. (2021). Cardiovascular Disease in Women and in Pregnancy. In: Gaggin, H.K., Januzzi Jr., J.L. (eds) MGH Cardiology Board Review. Springer, Cham. https://doi.org/10.1007/978-3-030-45792-1_7

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  • DOI: https://doi.org/10.1007/978-3-030-45792-1_7

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