Hypertrophic cardiomyopathy
If systolic ventricular function is preserved, pregnancy is generally well tolerated as the vasodilatory
effects of pregnancy are beneficial in patients without significant left ventricular outflow obstruction
[11]. However, atrial arrhythmias may occur as a result of increased atrial stretch and should be treated
promptly as they are not well tolerated because of diastolic dysfunction. The incidence of ventricular
arrhythmias and sudden cardiac death is not increased by pregnancy. Patients with significant outflow
tract obstruction, a history of ventricular arrhythmias and severe hypertrophy are at an increased risk of decompensation. Beta blockers may be used to reduce outflowtract obstruction and in the management
of arrhythmias. Patients with implantable defibrillators may undergo pregnancy provided that the
ventricular arrhythmias are adequately controlled. The highest risk period is around the time of delivery
and the first 48 h post partum as the rapid fluid shifts may precipitate heart failure and arrhythmias.