Left ventricular cardiomyopathies in pregnancy: clinical challenges, diagnosis, and management

PURPOSE OF REVIEW: Cardiovascular disease is a significant contributor to pregnancy-related morbidity and mortality. Pregnancy-related cardiovascular disease is increasing in incidence related to adult-onset cardiovascular disease and longer survival of patients with congenital heart disease. Left ventricular cardiomyopathies represent a marked subset of this patient population. Care for these patients remain complicated by fairly limited prospective data as well as complex care coordination between multiple different teams. RECENT FINDINGS: This review is intended to summarize diagnostic and management considerations for a variety of left ventricular cardiomyopathies that complicate pregnancy, anesthetic considerations affecting peripartum care, the development of the pregnancy heart team, and future therapeutic aims and research avenues. SUMMARY: Cardiovascular disease remains an extremely complicated disease process with promising avenues for research for earlier recognition and intervention to improve multidisciplinary care efforts and patient outcomes. Ongoing interest and work is needed in this field to continue promoting safe, multidisciplinary, and comprehensive care for pregnant patients with heart disease.