Which signs suggest end-organ damage from chronic hypertension during pregnancy?

Updated: Jun 12, 2018
  • Author: Michael P Carson, MD; Chief Editor: Edward H Springel, MD, FACOG  more...
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Answer

Answer

The presence of S4 on cardiac auscultation is not a normal finding in pregnancy. It suggests left ventricular hypertrophy (LVH) or diastolic dysfunction due to preeclampsia-induced vasospasm. Furthermore, in pregnancy, and particularly in the presence of preeclampsia, any sustained cardiac gallop may be a pathologic finding and warrants further evaluation with echocardiography. However, a well-conducted phonocardiographic study of pregnant women found a soft, intermittent S3 to be common in normal pregnancy.

Carotid bruits may reflect atherosclerotic disease due to longstanding hypertension, and Retinal changes of chronic hypertension may be noted.


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