When the woman with cardiac issues becomes pregnant, their heart endures increased stress due to increased blood volume and decreased afterload resulting in a decrease in cardiac output. Decreased cardiac output can lead to further cardiac decompensation and heart failure as the heart is not able to pump enough blood to meet the demands of the body.
As cardiac output decreases and heart failure progresses, fluid backs up into the lungs resulting in increased sensation to cough.
Dyspnea, orthopnea, rapid respirations (>25 breaths/min), and cyanosis of lips and nailbeds characterize signs of cardiac decompensation. When the pregnant patient with cardiac problems complains of a feeling of smothering, this often characterizes an early symptom of pulmonary edema. The health care provider should be alerted when this type of complaint is made by the patient.
The woman with cardiac insufficiency during pregnancy may start feeling as though their heart is racing. This occurs because the heart is trying to compensate by beating faster and harder to keep up with the increased blood supply.
As cardiac output decreases and the heart is no longer able to supply blood and oxygen throughout the body, the woman may feel more fatigued.
In an attempt to compensate, the heart beats faster to keep up with the demands of the body.
The woman with cardiac insufficiency during pregnancy may exhibit crackles in the bases of the lungs. This occurs due to fluid buildup in the lungs as a result of the heart being unable to pump fluid adequately.
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