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Pre-Eclampsia: Increases Risk of Cardiovascular Disease

It is now more appreciated that women who suffer pre-eclampsia have long-term increase risk of cardiovascular diseases. Therefore these women need to be aware of this life-long increased risk.

Women who had pre-eclampsia should be evaluated at least once in cardiology clinic to review there current risk factors for cardiovascular disease. Education about how to mitigate the risk of heart disease should emphasize a healthy lifestyle.

DiseaseLong-Term Risk
Hypertension3.74x
Type 2 Diabetes2.28x
Kidney Disease3.35x
High Cholesterol2.5x
Adverse cardiac outcome2.0x

Please be mindful of your risks and ensure:

  • Eat healthy diet high in fiber and fresh veggies/fruit
  • Avoid high salty foods
  • Maintain normal body weight (BMI <25)
  • Exercise 3-4x a week
  • Monitor Blood Pressure and treat if home BP >130/85
  • Check cholesterol (LDL) every year
  • Consider obtain a coronary artery calcium score at age 50
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Long COVID: Cardiac Symptoms

A significant percentage of patients after COVID-19 infection will have cardiac symptoms of tachycardia, palpitations, and chest pain.

The American College of Cardiology (ACC) has published an expert consensus document to provide an overall framework for the diagnosis and management of patients afflicted with persistent symptoms followed COVID19 infection: https://www.jacc.org/doi/10.1016/j.jacc.2022.02.003

The ACC terms persistent symptoms more than 4 weeks after COVID19 infection as post-acute sequelae of SARS-CoV-2 (PASC). PASC is a constellation of symptoms which can be non-specific. In my practice, I have seen dozens of patients with symptoms such as fatigue, exercise intolerance, orthostasis, shortness of breath, and palpitations after COVID19 infection. I have also seen a few patients with these symptoms after COVID19 vaccination.

A typical cardiology workup would include: 12 lead ECG, echocardiogram, and possibly ambulatory cardiac event monitoring (i.e. Holter). Referral to pulmonology may also be needed for pulmonary function testing (PFT).

I have treated a few patients with midodrine +/- fludrocortinsone to reduce orthostatic intolerance or POTS-like symptoms.

Unfortunately there is no clear and effective treatment. Hopefully the tincture of time will resolve the symptoms.