Cardiovascular Diseases in Pregnancy

Pregnancy heart Pregnancy, irrespective of the gravidity is an anxious period for a woman and the anxiety could be compounded manifold if there is a concomitant cardiovascular disease (CVD). In such situations, risk stratification and counseling become challenging tasks for the attending physician. India is on par with the western world in terms of the progress made in the treatment of congenital heart disease. Many patients who had undergone either palliative or corrective surgery in their childhood enter childbearing age. Moreover, there is also an increase in the prevalence of diabetes, hypertension and coronary artery disease. Physicians in India therefore are likely to see more CVD in addition to rheumatic heart disease (RHD) which currently remains the most common CVD seen during pregnancy in the country.

Key Point: The presence of cardiovascular diseases in pregnancy is a stressful situation both for patients as well as physicians. When a pregnant women presents with cardiovascular disease, would you reassure her or manage yourself or would you refer her to a specialist? The review focuses on these aspects to help you to offer informed choices for your patients.

The spectrum of CVD in pregnancy is wide and many expose the patients to increase risk in morbidity and mortality. When a pregnant woman is diagnosed with CVD, the physician is usually on the alert and involves the cardiologist in the patient’s care as early as possible. Nevertheless, some CVDs are elicited only during pregnancy or develop during pregnancy. In such situations, it is important for the physicians to have comprehensive knowledge on the recognition and management of these conditions, as patients are more likely to present concerns to their physician first prior to consulting a cardiologist. With early recognition and timely referral, a physician can play an important role in reducing the morbidity and mortality of pregnant women with CVD.

When CVD is diagnosed ...

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