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Medical/Surgical/Diseases/Complications

Poster Session 2

(466) EKG/ECHO findings among Black patients with positive cardiovascular risk assessment during pregnancy and postpartum

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Racial disparities exist in obstetrical care with an increased cardiovascular disease (CVD) related morbidity and mortality in non-Hispanic Black patients. Pregnancy related physiological changes in hemodynamics may cause symptoms that mimic CVD. We used a CVD risk assessment tool to identify obstetrical patients at-risk for CVD. We sought to determine if there are differences in abnormal echocardiogram (ECHO)/electrocardiogram (EKG) findings among Black and non-Black patients who screened positive.

Study Design: This was a prospective cohort of obstetrical patients who screened positive for CVD risk during pregnancy or postpartum from 6/15/2022 to 7/1/2023 at an inner-city academic hospital. Patients who screened positive were referred for ECHO, EKG, and Cardio-Obstetric consultation. Our primary outcome was the rate of CVD diagnosis based on ECHO/EKG diagnostic criteria. Secondary outcomes included rates of symptomatology, valvular abnormality on ECHO, and abnormal EKG.

Results: Of the 131 patients that screened positive for CVD risk, 71 (53.4%) self-identified as Black. Non-Black patients were more likely to report symptoms of shortness of breath (70.5% vs 48.6%, p= 0.013), orthopnea (44.3% vs 25.7%, p= 0.028), and rapid heart rate (57.4% vs 34.3%, p= 0.008) during pregnancy compared to Black patients. There were no significant differences in our primary outcome, 25 (50%) patients who completed the CVD workup were identified to have CVD in the Black group, CVD was identified in 20 (40.8%) of patients in the non-Black group. No significant differences in other diagnostic results were seen.

Conclusion: We found a significantly lower number of Black patients reporting symptoms that mimic CVD, yet race did not alter the rate of true CVD diagnosis in pregnancy. Increased prevalence of comorbidities in the Black race leading to CVD risk is a potential explanation, a multivariate analysis could further evaluate this finding. Cultural influences may be related to the discrepancies in symptomology among races, however more studies are warranted to further understand the drivers.