妊娠合并内科疾病—心脏病 ppt课件
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Blood viscosity increased to promote myocardial ischemia
• 你所经历的课堂，是讲座式还是讨论式？ • 教师的教鞭
• “不怕太阳晒，也不怕那风雨狂，只怕先生骂我 笨，没有学问无颜见爹娘 ……”
• “太阳当空照，花儿对我笑，小鸟说早早早……”
Physiological Changes 1
The first cardiovascular change associated with pregnancy
ventricular end-diastolic volume wall muscle mass contractility
Heart rate increase
10 to 15 beats per minute
6
Physiological Changes 3
Labour leads to further increases in cardiac output In the first stage: 15% In the second stage: 50%
Cardiac Disease in Pregnancy
Women's Hospital School of Medicine Zhejiang University
1
Physiological Changes in the Cardiovascular System During Pregnancy
10
Left → right shunt ① atrial septal defect ② ventricular septal defect ③ patent ductus arteriosus
Congenital heart disease
No shunt ① pulmonary artery stenosis ② coarctation of the aorta ③ Marfan syndrome
Peripheral vasodilation (induced by progesterone)
leading to
A decrease in systemic vascular resistance
5
Physiological Changes 2
Cardiac output increases 8 weeks : 20% 20-28 weeks :40-50% Stroke volume increase 80ml/t
• right → Left shunt: • Tetralogy of Fallot 、
Eisenmenger's syndrome
11
Rheumatic heart disease
Aortic stenosis: severe Pulmonary edema Low discharge capacity heart failure Aortic incompetence : severe Left ventricular failure Bacterial endocarditis
7
Physiological Changes 4
After delivery, cardiac output increases again immediately : 60-80%
sudden interruption of placental circulation uterine contraction relief of caval compression within 1 h: rapid decline to pre-labour values
Puerperium:
uterine contractions retented Interstitial fluid returned to circulation return to normal after 2 weeks
8
Physiological Changes 5
The greatest change period in systemic blood circulation and heart burden
abdominal pressure plummeted pain and anxiety : sympathetic stimulation pulmonary artery pressure increased blood back into the circulation with each uterine contraction: 300-500 ml
12
HDIP heart disease
No history of heart disease and signs Sudden onset of systemic failure
left ventricular failure
Peripheral small artery resistance increased Myocardial ischemia, interstitial edema, hemorrhage and necrosis spots
32 to 34 weeks Intrapartum 3 days postpartum
Easily induced heart failure
9
Types of CD during pregnancy
Congenital heart disease Rheumatic heart disease Hypertensive disorders in pregnancy heart disease Peripartum cardiomyopathy Other
A thorougБайду номын сангаас knowledge
essential
In order to understand
the additional impact of cardiac disease
2
精品资料
• 你怎么称呼老师？
• 如果老师最后没有总结一节课的重点的难点，你 是否会认为老师的教学方法需要改进？
• 你所经历的课堂，是讲座式还是讨论式？ • 教师的教鞭
• “不怕太阳晒，也不怕那风雨狂，只怕先生骂我 笨，没有学问无颜见爹娘 ……”
• “太阳当空照，花儿对我笑，小鸟说早早早……”
Physiological Changes 1
The first cardiovascular change associated with pregnancy
ventricular end-diastolic volume wall muscle mass contractility
Heart rate increase
10 to 15 beats per minute
6
Physiological Changes 3
Labour leads to further increases in cardiac output In the first stage: 15% In the second stage: 50%
Cardiac Disease in Pregnancy
Women's Hospital School of Medicine Zhejiang University
1
Physiological Changes in the Cardiovascular System During Pregnancy
10
Left → right shunt ① atrial septal defect ② ventricular septal defect ③ patent ductus arteriosus
Congenital heart disease
No shunt ① pulmonary artery stenosis ② coarctation of the aorta ③ Marfan syndrome
Peripheral vasodilation (induced by progesterone)
leading to
A decrease in systemic vascular resistance
5
Physiological Changes 2
Cardiac output increases 8 weeks : 20% 20-28 weeks :40-50% Stroke volume increase 80ml/t
• right → Left shunt: • Tetralogy of Fallot 、
Eisenmenger's syndrome
11
Rheumatic heart disease
Aortic stenosis: severe Pulmonary edema Low discharge capacity heart failure Aortic incompetence : severe Left ventricular failure Bacterial endocarditis
7
Physiological Changes 4
After delivery, cardiac output increases again immediately : 60-80%
sudden interruption of placental circulation uterine contraction relief of caval compression within 1 h: rapid decline to pre-labour values
Puerperium:
uterine contractions retented Interstitial fluid returned to circulation return to normal after 2 weeks
8
Physiological Changes 5
The greatest change period in systemic blood circulation and heart burden
abdominal pressure plummeted pain and anxiety : sympathetic stimulation pulmonary artery pressure increased blood back into the circulation with each uterine contraction: 300-500 ml
12
HDIP heart disease
No history of heart disease and signs Sudden onset of systemic failure
left ventricular failure
Peripheral small artery resistance increased Myocardial ischemia, interstitial edema, hemorrhage and necrosis spots
32 to 34 weeks Intrapartum 3 days postpartum
Easily induced heart failure
9
Types of CD during pregnancy
Congenital heart disease Rheumatic heart disease Hypertensive disorders in pregnancy heart disease Peripartum cardiomyopathy Other
A thorougБайду номын сангаас knowledge
essential
In order to understand
the additional impact of cardiac disease
2
精品资料
• 你怎么称呼老师？
• 如果老师最后没有总结一节课的重点的难点，你 是否会认为老师的教学方法需要改进？