Cardiac Diagnoses in Obstetric Patients: An Observational Trimester-Based Analysis from Patients Undergoing Cardiology Consultations

OBJECTIVE
The aim of this study is to evaluate the frequency of cardiac complaints and diagnosed cardiovascular diseases across trimesters in pregnant women referred for cardiology consultations.


METHODS
This retrospective observational study was conducted at a second-level state hospital. Pregnant women referred to the cardiology clinic between September 2020 and March 2022 were included. Data collected included demographic information, clinical presentations, trimester of pregnancy, blood pressure, heart rate, anemia status, electrocardiography (ECG), and echocardiographic findings. Cardiac diagnoses were based on clinical evaluation, ECG, and echocardiographic findings.


RESULTS
A total of 658 pregnant women were included, with a mean age of 28.18 (± 4.28) years. Most consultations occurred in the third trimester (49.1%). Primary reasons for consultation were palpitations (48%), chest pain (21.3%), leg edema (13.1%), and high blood pressure (11.6%). Anemia was present in 28.7% of the women, and 20.2% had hypertension (HT). Significant differences across trimesters included higher rates of chest pain and presyncope/syncope in the first trimester, and higher rates of palpitations and anemia in the second and third trimesters. The most common cardiac diagnoses were arrhythmias (16.6%), high blood pressure (15.2%), and mitral regurgitation (MR) (12.5%). Hypertension was most frequently diagnosed in the second trimester (P = 0.04). Infective endocarditis, myocarditis, and pericarditis were more common in the third trimester.


CONCLUSION
Cardiac consultations are most frequent in the third trimester, with palpitations, chest pain, and high blood pressure being the most common complaints. Hypertension and MR are the most common cardiac diagnoses. Early and ongoing cardiologic assessment during pregnancy is crucial for managing cardiovascular risks.