Cardiovascular Diseases & Diagnosis

Symptomatic, non-hospitalized patients with coronavirus disease-2019 (COVID-19) who are at high risk of progressing to severe disease are treated with nirmatrelvir-ritonavir (NMVr). COVID-19 adverse events are more likely to occur in people who have cardiovascular risk factors as well as cardiovascular disease. As a result, they are more likely to receive NMVr. The pharmaceutical enhancer in NMVr, ritonavir, affects the P-glycoprotein pump and is an inhibitor of the CYP450 pathway's enzymes, particularly CYP3A4 and, to a lesser extent, CYP2D6. It is possible for NMVr to interact significantly with medications commonly used to treat cardiovascular conditions, which could result in severe side effects. It is essential to be aware of such interactions and to take preventative measures. In this survey, we examine potential medication drug communications among NMVr and regularly utilized cardiovascular prescriptions in light of their pharmacokinetics and pharmacodynamic properties.

The management of cardiovascular disease during pregnancy necessitates a team approach, and cardio-obstetrics has emerged as an important multidisciplinary field. Myocardial infarction, cardiomyopathies, arrhythmias, valvular disease, thromboembolic disease, aortic disease, and cerebrovascular diseases are among the cardiac conditions that can occur during pregnancy. Pregnancy-related mortality in the United States is primarily attributed to cardiovascular disease. Rates of maternal mortality have risen as a result of rising maternal age and preexisting comorbid conditions. Women with preexisting cardiac conditions or a history of preeclampsia must receive preconception counseling from the multidisciplinary cardio-obstetrics team. It is essential to involve the cardio-obstetrics team as soon as possible to avoid maternal morbidity and mortality throughout the pregnancy and the first year after delivery. All cardiovascular and primary care clinicians should have a fundamental understanding of cardiovascular disease during pregnancy. An overview of the diagnosis and treatment of cardiovascular disease during pregnancy is provided in this scientific statement.