Non-invasive multimodality imaging and special treatment considerations for pericarditis in pregnancy.
Autor: | Karmali R; Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA., Motairek I; Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA., Mazumder S; Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA., Berglund F; Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA., Braghieri L; Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA., Al-Dalakta A; Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA., Singh K; Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland OH, USA., Weber B; Heart and Vascular Center, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts, USA., Klein A; Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA. Electronic address: kleina@ccf.org. |
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Jazyk: | angličtina |
Zdroj: | The American journal of cardiology [Am J Cardiol] 2024 Dec 10. Date of Electronic Publication: 2024 Dec 10. |
DOI: | 10.1016/j.amjcard.2024.12.007 |
Abstrakt: | Pericarditis in women who are pregnant or of childbearing age poses a challenge to clinicians. Currently, there are no guidelines regarding the optimal approach for managing pericarditis in pregnancy with regards to selecting the appropriate method of diagnostic imaging or tailoring the treatment regimen to gestational age. Pericarditis in pregnancy may manifest as an autoimmune or autoinflammatory phenotype but the predominant etiology is idiopathic. Transthoracic echocardiography and cardiac magnetic resonance are considered safe, but data is lacking on the use of gadolinium-based contrast agents. Shared-decision making is paramount to balance risks and benefits of radiation and contrast exposure to the mother and fetus. The safety profile of treatment options differs at each time-interval from preconception to the three trimesters and postpartum phase. A multidisciplinary approach using imaging guidance can improve outcomes in pregnant patients with pericarditis. Further studies are needed to ascertain the safety of Interleukin-1 blocking agents in pregnancy. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024. Published by Elsevier Inc.) |
Databáze: | MEDLINE |
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