2. Heart disease & pregnancy Dr Movahedi

3. Clinical indicators of Hear disease & pregnancy

4. Symptoms : Progressive dyspnea or orthopnea Nocturnal cough Hemoptysis Syncope Chest pain

5. Sings : Cyanosis Cubbing of fingers Persistent neck vein distension Systolic murmur > or = 3/6 Diastolic murmur Cardiomegaly

6. …. Sings : Persistent arrhythmia Persistent split second sound Criteria for pulmonary hypertension

7. Clinical classification of heart disease

8. Class I uncompromised Class II slight limitation Ph.A Class III marked limitation Ph.A Class IV severely compromised

9. Predictors of cardiac complicators

10. * Prior heart failure, TIA, arrhythmia – stroke *Class III or IV or cianosis *left-side obstruction mitral value area < 2 Cm 2 Aortic value area < 1.5 Cm 2 Peak left ventilator gradient > 30 mmHg * EF < 40 %

16. Peripartum cardiomyopathy 1- cardiac failure in the last month or within 5 months 2- absence of cause for failure. 3- absences of prior hard disease. 4- Left ventricular systolic dysfunction.