Anesthesia for Pregnant Patient with Cardiac Disease

Abstract

Management of pregnant women with heart disease has always been challenging. However, owing to recent novelties in cardiac surgery and correction of cardiac anomalies as well as the successful performance of heart transplants, it is possible that cardiac diseases will coexist with pregnancy and the frequency will increase in future. Using proper approach with respect to the suitable use of analgesics and anesthetics, in addition to both the pathophysiology and pharmacological therapy regarding the parturient, how these interact with anesthetic care should be considered meticulously. Although the conditions of cardiac pathology such as congenital or acquired, functional or structural, cyanotic or noncyanotic, and endocardial, myocardial, or pericardial defects may not have shown symptoms during non-pregnancy state, they become evident during mid-to-late pregnancy as an outcome of developing physiologic hemodynamic stresses. When the pregnant patient is encountered by the anesthetist, different structural lesions might be uncorrected, fully corrected, or partially corrected. Most of the time, since a single approach to the management of cardiac lesions is not present, a concurrence on the optimal anesthetic technique does not exist. © Springer International Publishing AG, part of Springer Nature 2018.