Antenatal Cardiac Risk Assessment: Insights from Dr. Garima Sharma

Dr. Garima Sharma, a leading expert in women's cardiovascular health, has highlighted the critical need for comprehensive antenatal cardiac risk assessments and structured postpartum follow-ups. During a recent discussion, she emphasized that these measures are essential for managing cardiovascular risks associated with pregnancy. The insights were shared in her capacity as the Martha Schar Chair of Women’s Cardiovascular Health and Director of Preventive Cardiology at Inova Schar Heart and Vascular.

Sharma pointed out that several validated risk scores, such as the modified WHO classification of heart disease and CARPREG II, are routinely employed in cardio-obstetrics. These tools allow healthcare providers to anticipate potential complications based on specific cardiac conditions and should be incorporated into the antenatal care pathway. Additionally, screening pathways endorsed by organizations like the American College of Obstetricians and Gynecologists guide clinicians in managing these risks effectively.

The physician stressed the importance of recognizing signs of cardiac decompensation, which may include worsening shortness of breath, palpitations, and abnormal blood pressure readings. According to Sharma, these symptoms should not be overlooked, as they necessitate a thorough clinical history and appropriate diagnostic tests, including echocardiograms or EKGs, depending on symptom severity. Early involvement of cardiologists is crucial, especially for patients who may be unaware of underlying heart conditions.

Sharma also addressed the challenges of postpartum care, noting that adverse pregnancy outcomes can manifest even in patients without prior cardiac history. Conditions like preeclampsia or gestational diabetes may arise, highlighting the need for clear communication of future health risks to patients and their families. Establishing a solid transition plan from obstetric to primary care is vital to ensure ongoing health monitoring and management.

Looking ahead, Sharma advocates for enhanced collaboration between obstetricians and cardiologists to improve outcomes for high-risk patients. She urges that postpartum screenings and continuous care must be prioritized to prevent these patients from falling through the cracks in the healthcare system. The need for systemic changes in obstetrical care frameworks is evident to address these critical health needs effectively.