Cardiologists are often confronted with pregnant women in distress with heart disease. Obstetricians promptly refer them to cardiologists.
There is a tendency among cardiologists, to make fun of obstetricians who some times call them for frivolous cardiac problem at odd hours .(Say a VPD in the monitor or a systolic murmur of anemia etc)
Of course , this doesn’t mean in any way , cardiologists belong to a superior species ! The fact is , many cardiologists fare poorly in their knowledge about the hemodynamics of pregnancy (Let them prove this wrong !)
A small quiz . . . for all cardiologists
- How much of blood enter the maternal circulation after each uterine contraction during active labor ?
- Is the stress of normal delivery is greater than that of cesarean section under epidural anesthesia ?
- What anesthetic agent is ideal in patients with pulmonary hypertension ?
- How safe is general anesthesia in a hypotensive , heart disease patient ?
- What is the clinical significance of administering IV anesthetic vs inhaled anesthetic in a patient with right left shunt lesions ?
If a cardiologist is able to answer all these 5 questions correctly without guessing , probably they have the right to make fun of obstetricians or else they have to quietly buy this book and read !
Final message
Every responsible cardiologist must have good awareness about hemodynamic stress of pregnancy and the intricacies of obstetrical anesthesia
Dr.S.Venkatesan MD 