Congenital Heart Disease in Pregnancy Lindsey Green PGY1

Congenitally Corrected Transposition of the Great Arteries L- TGA Asymptomatic at birth unless another lesion present (VSD or ASD) If no other lesion, present in adulthood with arrhythmia and/or heart failure. On PE, loud S2 EKG: Q waves in right precordial leads (V1,V3) In pregnancy, arrhythmias: 4% , Heart Failure: 7%, cardiovascular events: 2%

Transposition of the Great Vessels D-TGA Systemic and pulmonary circulations exist in parallel ( 2 closed systems) Require arterial switch repairs In Pregnancy, arrhythmias: 15.6%, Heart Failure: 10.8%, cardiovascular events 2.2%

Ebstein’s Anomaly Associated with lithium use in mother while pregnant Varying tricuspid leaflet size: attach to septum and walls of RV: Atrialization of the right ventricle ( small right ventricle and large right atria) EKG: tall broad “himalayan” p waves. Frequently RBBB WPW associated arrhythmia, Complete heart block In Pregnancy (acyanotic woman), arrhythmias: 3.9%, Heart Failure: 3.1%, no cardiovascular events.