The physiological 50 per cent increase in cardiac output during normal pregnancy highlights the significant hemodynamic burden placed on patients with pre-existing heart disease.
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Alerts clinicians to monitor pregnant patients with heart disease closely; leaves open optimal management strategies pending higher-level evidence.
That the heart output increases during pregnancy has been demonstrated in both animals and the human being.1In a normal pregnancy the cardiac output begins to increase at about the fourth month, from which time on there is a steady rise until term is reached. This increase in cardiac output during normal gestation, expressed in terms of volume of blood passing through the heart in unit time, is approximately 50 per cent. Following delivery the minute volume slowly returns to normal, reaching its nonpregnant level within four weeks. Unfortunately, as yet, we are ignorant of the cardiac output or work during the period of labor, although there is reason to believe that it is further augmented during parturition. It is evident that such a marked increase in the minute volume of the heart during gestation must be of the utmost importance in patients suffering from some cardiac disturbance. This
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H.J. Stander (1937) studied this question.
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