17. Cardiac Disease

  1. John T. Queenan MD3,
  2. Catherine Y. Spong MD4 and
  3. Charles J. Lockwood MD5
  1. Stephanie R. Martin DO1,
  2. Alexandria J. Hill MD2 and
  3. Michael R. Foley MD2

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch17

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Martin, S. R., Hill, A. J. and Foley, M. R. (2012) Cardiac Disease, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch17

Editor Information

  1. 3

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 4

    Bethesda, MD, USA

  3. 5

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. 1

    Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA

  2. 2

    Department of Obstetrics and Gynecology, University of Arizona, Tucson, AZ, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • cardiac disease;
  • rheumatic to congenital, mitral valve diseases;
  • pregnancy assessment in cardiac disease, challenging;
  • NYHA, functional status for patients with cardiac disease;
  • hemodynamic changes in pregnancy;
  • pregnancy, and cardiovascular, clotting factor changes;
  • mitral valve prolapse;
  • PPCM, criteria for diagnosis;
  • valvular heart disease;
  • congenital cardiac abnormalities, tetralogy of Fallot, Marfan syndrome

Summary

Advances in diagnosis and treatment of congenital cardiac lesions have led to dramatically improved survival rates. Consequently, the predominant form of cardiac disease encountered during pregnancy has shifted from rheumatic to congenital heart disease. Despite complicating only 4% of all pregnancies in the United States, a disproportionate number of maternal deaths (34%) can be attributed to cardiac disease. Approximately 15% of maternal intensive care unit admissions are attributable to cardiac disease, but it accounts for up to 50% of all maternal deaths in the ICU. Assessment of the pregnant patient with cardiac disease can be challenging, as many common complaints of normal pregnancy, such as dyspnea, fatigue, palpitations, orthopnea, and pedal edema, mimic symptoms of worsening cardiac disease. Obstetric patients with cardiac disease are susceptible to a number of potential complications resulting from significant physiologic changes associated with pregnancy and delivery. This chapter outlines the expected hemodynamic and physiologic changes occurring in pregnancy and reviews prognosis and management recommendations for obstetric patients with congenital and acquired cardiac lesions.