Peripartum Cardiomyopathy
Background
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Definition: new heart failure that develops in the last month of pregnancy or in the first 5 months postpartum
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Echocardiogram findings: global dilation & dysfunction, strict criteria for EF ≦ 45%
Anesthetic Considerations
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High risk cardiac patient & a very high risk of maternal/fetal M&M
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Management at a cardiac centre in a multidisciplinary team setting
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Management of cardiac medications & possible anti-coagulation
Anesthetic Management
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Detailed review of functional capacity, echocardiogram, cardiology consults, & medications
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Epidural, spinal, & GA are acceptable if goals met
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Neuraxial may be contraindicated if patient anticoagulated
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Set up OR for vasopressors, inotropes
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Manage in a tertiary cardiac centre with invasive monitoring (arterial line, ± CVP/PAC) + TEE capability
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Post-op ICU