Cardiogenic Shock

Cardiogenic shock often precedes maternal death. Cardiogenic shock is caused by failure of the heart to pump effectively. Cardiogenic shock is characterized by systemic hypoperfusion in the setting of adequate intravascular volume. This chapter emphasizes the usefulness of early coronary angiography after acute myocardial infarction in pregnancy. Peripartum cardiomyopathy is cardiomyopathy that develops in the last gestational month of pregnancy or in the first 5 months postpartum. Rheumatic mitral stenosis is the most common clinically significant valvular abnormality in pregnant women and may be associated with pulmonary congestion, edema, and atrial arrhythmias during pregnancy or soon after delivery. Patients with severe aortic stenosis, with or without symptoms, are at highest risk for cardiac decompensation during pregnancy. The majority of cases of acute aortic dissection during pregnancy occur as the result of Marfan’s syndrome and coarctation of the aorta. Acute right-sided heart failure is less common than left-sided heart failure but can result in profound shock.