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Stable ischemic heart disease — RCPSC IM MCQ

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HardCardiologyStable ischemic heart diseaseRCPSC IM

A woman with systemic lupus erythematosus plans pregnancy. Disease has been clinically quiet for nine months on hydroxychloroquine and azathioprine; creatinine and urine sediment are normal. What medication principle best reduces maternal flare risk?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Continue hydroxychloroquine through pregnancy unless contraindicated

Hydroxychloroquine is generally continued in pregnancy because stopping it increases flare risk. Mycophenolate is teratogenic, chronic high-dose prednisone adds harm, and stopping all treatment is unsafe. Medication planning should occur preconception with rheumatology and obstetric input.

Reference: Canadian Rheumatology Association, Clinical Guidelines and Position Statements: https://rheum.ca/resources/publications/