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Cardiovascular disease in pregnancy is present in 0.1 to 4.0% of those in developed countries and 0.6% in developing countries. It accounts for 18% of ICU admissions in the United States. The incidence is increasing due to increases in obesity, hypertensive diseases, advanced maternal age, and repair of complex congenital heart diseases. The physiologic changes to the cardiovascular system lead to a state of high flow and low resistance in pregnancy. This causes physical exam findings that mimic cardiac disease in pregnancy, making the diagnosis, treatment, and management of cardiac disease even more difficult for clinicians. Each cardiac disease poses unique risks and potential complications during pregnancy, labor, delivery, and postpartum. Preconception counseling, complete understanding of physiologic changes to the cardiovascular system during pregnancy, multidisciplinary team approach, and delivery in a tertiary care center are the keys to the successful management of patients with cardiac disease in pregnancy. This review contains 4 figures, 6 tables, and 45 references. Key Words: aortic stenosis, cardiac disease, cardiac risk assessment, congenital heart disease, endocarditis prophylaxis, Marfan syndrome, mechanical valve, mitral stenosis, pregnancy, pulmonary arterial hypertension |
