Cardiac disease in the pregnant pat

Cardiac disease in the pregnant patient can present challenges in cardiovascular and maternal-fetal management.1 It is important to understand that even in normal patients, pregnancy imposes some dramatic physiologic changes upon the cardiovascular system. These include an increase in plasma volume by 50%, an increase in resting pulse by 17%, and an increase in cardiac output by 50%. After delivery, the heart rate normalizes within 10 days; by 3 months postpartum, stroke volume, cardiac output, and systemic vascular resistance return to the pre-pregnancy state. General guidelines for the management of pregnant women with heart disease are outlined below.