Heart disease in pregnancy

Pregnancy is a vasodilator state in which plasma volume and cardiac output increase such that many symptoms and signs of cardiac disease can occur physiologically. Disproportionate symptoms or abnormal signs such as a diastolic murmur require investigation as usual; necessary radiological investigations should not be withheld as the risks to the fetus are generally low. This chapter looks at the various aspects of pre-pregnancy risk assessment and delivery of the baby; heart conditions arising in pregnancy (e.g. peripartum cardiomyopathy, myocardial infarction); and managing heart conditions in pregnant women, such as valve diseases and cardiomyopathies, hypertrophic cardiomyopathy, congenital cardiac lesions, and anticoagulation.