Heart disease, though rare, is in Western countries a major cause of maternal
mortality. Heart disease can be present or discovered during pregnancy because
of haemodynamic overload of the heart, particularly during the third trimester
when cardiac output doubles.
Most of the knowledge in recognition and treatment of cardiac disease during
pregnancy is not based on evidence from randomized trials, but is derived from
clinical experience, few case reports, and small consecutive series. These are
summarized in the guidelines on ‘Management of Cardiovascular Diseases During
Pregnancy’ from the European Society of Cardiology, the basis for this chapter.
The physiological changes that occur during pregnancy have a different impact
depending on the type and severity of cardiac anomalies. Differential diagnosis
with normal pregnancy related physiological changes is also discussed....