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The ECG in Normal Pregnancy

The ECG in Normal Pregnancy Abstract The clinician is often consulted to examine a pregnant woman for the presence of cardiovascular disease. Delineation of heart disease during pregnancy may be especially difficult, as the considerable hemodynamic changes that occur during normal pregnancy typically produce signs and symptoms that mimic cardiovascular disorders. Dyspnea, fatigue, palpitations, and chest discomfort are commonly described by normal pregnant women but are rarely of a severity to limit usual daily activities; syncope is a less frequent complaint. Progressive augmentation of the resting cardiac output begins in the first trimester and increases to 30% to 50% above normal in the second and third trimesters. Although sodium and water retention partly explain these hemodynamic alterations, the effect of steroid hormones is thought to predominate; the placental low-resistance shunt is not considered a major factor. These features explain the frequent occurrence of peripheral edema, jugular venous distention with prominent neck vein pulsations, a prominent third References 1. Adams JQ: Cardiovascular physiology in normal pregnancy: Studies with the dye dilution technique. Am J Obstet Gynecol 1954;67:741-759. 2. Benjamin ZH: Duration of the QT interval in normal pregnant women. Am Heart J 1949;38:119-122.Crossref 3. Burwell CA, Metcalfe J: Heart Disease and Pregnancy: Physiology and Management. Boston, Little Brown & Co, 1958. 4. Carr FB, Hamilton BE, Palmer RS: The significance of large Q in lead III of the electrocardiogram during pregnancy. Am Heart J 1932 -1933;8:519-524.Crossref 5. Carr FB, Palmer RS: Observations on electrocardiography in heart disease associated with pregnancy with especial reference to axis deviation. Am Heart J 1932-1933;8:238-241.Crossref 6. Cunningham I: Cardiovascular physiology of labour and delivery: End report of a scientific meeting—Birmingham and Midland Obstetrical and Gyneacological Society, May 7, 1965. J Obstet Gynaecol Br Commonw 1966;73:500. 7. Hollander AG, Crawford JH: Roentgenologic and electrocardiographic changes in the normal heart during pregnancy. Am Heart J 1943;26:364-376.Crossref 8. Jensen FG, Norgaard: Studies on the functional cardiac diseases and the essential cardiac hypertrophy in normal pregnant women. Acta Obstet Gynecol Scand 1927;6:67-108.Crossref 9. McAnulty JH, Metcalfe J, Ueland K: Heart disease and pregnancy , in Hurst JW (ed): The Heart , ed 5. New York, McGraw-Hill Book Co, 1982, p 1521. 10. Rovinsky JJ, Jaffin H: Cardiovascular hemodynamics in pregnancy: II. Cardiac output and left ventricular work in multiple pregnancy. Am J Obstet Gynecol 1966;95:781-786. 11. Rovinsky JJ, Jaffin H: Cardiovascular hemodynamics in pregnancy: III. Cardiac rate, stroke volume, total peripherial resistance and central blood volume in multiple pregnancy: Synthesis of results. Am J Obstet Gynecol 1966;95:787-794. 12. Szekely P, Smith L: Heart Disease and Pregnancy. New York, Churchill Livingstone, 1974. 13. Wenger NK, Hurst JW, Strozier VN: Electrocardiographic changes in pregnancy. Am J Cardiol 1964;13:774-778.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The ECG in Normal Pregnancy

Archives of Internal Medicine , Volume 142 (6) – Jun 1, 1982

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340190044006
Publisher site
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Abstract

Abstract The clinician is often consulted to examine a pregnant woman for the presence of cardiovascular disease. Delineation of heart disease during pregnancy may be especially difficult, as the considerable hemodynamic changes that occur during normal pregnancy typically produce signs and symptoms that mimic cardiovascular disorders. Dyspnea, fatigue, palpitations, and chest discomfort are commonly described by normal pregnant women but are rarely of a severity to limit usual daily activities; syncope is a less frequent complaint. Progressive augmentation of the resting cardiac output begins in the first trimester and increases to 30% to 50% above normal in the second and third trimesters. Although sodium and water retention partly explain these hemodynamic alterations, the effect of steroid hormones is thought to predominate; the placental low-resistance shunt is not considered a major factor. These features explain the frequent occurrence of peripheral edema, jugular venous distention with prominent neck vein pulsations, a prominent third References 1. Adams JQ: Cardiovascular physiology in normal pregnancy: Studies with the dye dilution technique. Am J Obstet Gynecol 1954;67:741-759. 2. Benjamin ZH: Duration of the QT interval in normal pregnant women. Am Heart J 1949;38:119-122.Crossref 3. Burwell CA, Metcalfe J: Heart Disease and Pregnancy: Physiology and Management. Boston, Little Brown & Co, 1958. 4. Carr FB, Hamilton BE, Palmer RS: The significance of large Q in lead III of the electrocardiogram during pregnancy. Am Heart J 1932 -1933;8:519-524.Crossref 5. Carr FB, Palmer RS: Observations on electrocardiography in heart disease associated with pregnancy with especial reference to axis deviation. Am Heart J 1932-1933;8:238-241.Crossref 6. Cunningham I: Cardiovascular physiology of labour and delivery: End report of a scientific meeting—Birmingham and Midland Obstetrical and Gyneacological Society, May 7, 1965. J Obstet Gynaecol Br Commonw 1966;73:500. 7. Hollander AG, Crawford JH: Roentgenologic and electrocardiographic changes in the normal heart during pregnancy. Am Heart J 1943;26:364-376.Crossref 8. Jensen FG, Norgaard: Studies on the functional cardiac diseases and the essential cardiac hypertrophy in normal pregnant women. Acta Obstet Gynecol Scand 1927;6:67-108.Crossref 9. McAnulty JH, Metcalfe J, Ueland K: Heart disease and pregnancy , in Hurst JW (ed): The Heart , ed 5. New York, McGraw-Hill Book Co, 1982, p 1521. 10. Rovinsky JJ, Jaffin H: Cardiovascular hemodynamics in pregnancy: II. Cardiac output and left ventricular work in multiple pregnancy. Am J Obstet Gynecol 1966;95:781-786. 11. Rovinsky JJ, Jaffin H: Cardiovascular hemodynamics in pregnancy: III. Cardiac rate, stroke volume, total peripherial resistance and central blood volume in multiple pregnancy: Synthesis of results. Am J Obstet Gynecol 1966;95:787-794. 12. Szekely P, Smith L: Heart Disease and Pregnancy. New York, Churchill Livingstone, 1974. 13. Wenger NK, Hurst JW, Strozier VN: Electrocardiographic changes in pregnancy. Am J Cardiol 1964;13:774-778.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1982

References