Diagnostic Testing During Pregnancy

Diagnostic Testing During Pregnancy

Testing may be used during pregnancy to diagnose suspected heart disease and/or to periodically assess cardiac function. Many diagnostic cardiac tests are safe to use during pregnancy with the exception of tests with X-rays or nuclear studies.

The electrocardiogram may detect arrhythmias or irregular heartbeats, problems with the conduction electrical system or evidence of prior cardiac problems. It is a safe test during pregnancy.

The 24-hour or 48-hour cardiac event monitors are ordered for women who are experiencing daily palpitations to determine if heart rates are faster that normal or if there is an abnormal heart rhythm present. If the symptoms do not occur daily, an event monitor may be used to detect abnormal heart rhythms that occur sporadically over a 30-day period.

The echocardiogram, an ultrasound of the heart, is often used during pregnancy. It is safe to use and may be combined with a Doppler to study valve flow within the heart and assess overall cardiac function. This test may be performed frequently during pregnancy to update a physician on a woman's cardiac status.

The transesophageal echocardiogram (TEE) requires the placement of a probe in the esophagus. This test may be indicated to look for certain problems within the heart such as infection, blood clot or cardiac problems that cannot be well seen with the standard echocardiogram. The risk of the transesophageal echocardiogram is the required sedation but the test should be performed if determined to be necessary for care.

Magnetic resonance imaging (MRI) may also be performed in pregnancy although there is a radiation risk and it is best done after the middle of the second trimester.

Cardiac catheterization and angioplasty, which require X-ray exposure, are only done when clinically necessary. The abdomen is shielded to protect the developing fetus.

Nuclear imaging is contraindicated during pregnancy because nuclear isotopes concentrate in the bladder and have direct exposure to the developing fetus.