Clinical classification (By the New York Heart Association) Class I Uncompromised Patients with cardiac disease and no limitation of physical activity. They do not have symptoms of cardiac insufficiency, nor do they experience anginal pain. Class II Slightly compromised: Patients with cardiac disease and slight limitation of physical activity. These women are comfortable at rest, but if ordinary physical activity is undertaken, discomfort results in the form of excessive fatigue palpitation, dyspnea, or anginal pain
Clinical Classification (By the New York Heart Association) Class I Uncompromised: Patients with cardiac disease and no limitation of physical activity. They do not have symptoms of cardiac insufficiency, nor do they experience anginal pain. Class II Slightly compromised: Patients with cardiac disease and slight limitation of physical activity. These women are comfortable at rest, but if ordinary physical activity is undertaken, discomfort results in the form of excessive fatigue, palpitation, dyspnea, or anginal pain
Clinical Classification (con't Class l Markedly compromised Patients with cardiac disease and marked limitation of physical activity. They are comfortable at rest, but less than ordinary physical activity causes discomfort by excessive fatigue, palpitation, dyspnea, or anginal pain. Class lv Severely compromised: Patients with cardiac disease and inability to perform any physical activity without discomfort. Symptoms of cardiac insufficiency or angina may development at rest, and if any physical activity is undertaken. discomfort is increased
Class III Markedly compromised: Patients with cardiac disease and marked limitation of physical activity. They are comfortable at rest, but less than ordinary physical activity causes discomfort by excessive fatigue, palpitation, dyspnea, or anginal pain. Class IV Severely compromised: Patients with cardiac disease and inability to perform any physical activity without discomfort. Symptoms of cardiac insufficiency or angina may development at rest, and if any physical activity is undertaken, discomfort is increased. Clinical Classification (con’t)
Diagnosis of heart disease Many of the physiological changes of normal pregnancy tend to make the diagnosis of heart disease more difficult Disease history, Symptoms and Clinical Findings Listed in here symptoms and clinical findings may indicate heart disease
Diagnosis of heart disease Many of the physiological changes of normal pregnancy tend to make the diagnosis of heart disease more difficult. Disease history, Symptoms and Clinical Findings Listed in here symptoms and clinical findings may indicate heart disease:
Symptoms Severe or progressive dyspnea Progressive orthopnea Paroxysmal nocturnal dyspnea Hemoptysis Syncope with exertion Chast pain related to effort or emotion Clinical Findings Cvanosis Clubing of fingers
• Severe or progressive dyspnea • Progressive orthopnea • Paroxysmal nocturnal dyspnea • Hemoptysis • Syncope with exertion • Chast pain related to effort or emotion • Clinical Findings • Cyanosis • Clubing of fingers Symptoms
Symptoms (con Persistent neck vein distension Systolic murmur greater than grade 3/6 Diastolic murmur Cardiomegaly Sustained arrhythmia Persistent split second sound Criteria for pulmonary hypertension Left parasternal lift Loud p2
• Persistent neck vein distension • Systolic murmur greater than grade 3/6 • Diastolic murmur • Cardiomegaly • Sustained arrhythmia • Persistent split second sound • Criteria for pulmonary hypertension • Left parasternal lift • Loud P2 Symptoms (con’t)