Cardiac problems in pregnancy. I. Maternal aspects: the approach to the pregnant patient with heart disease

RAPID progress in the field of cardiology during the past decade has resulted in the development of new technology and its application to more sophisticated diagnosis and therapy. This development has led to vast improvements in the medical care available to all cardiac patients, including pregnant women. These developments, it seems, should have made it possible now for most cardiac patients to carry a pregnancy to a successful outcome. The purpose of this article is therefore to assess the recommended current approach to treatment of the pregnant patient with heart disease in view of recent progress in cardiovascular medicine. The approach to medical care in the cardiac patient has gone through a significant liberalization process over the years. While the early literature viewed pregnancy as contraindicated for all patients with valvular heart disease,1later reports suggested that therapeutic abortions are rarely indicated for patients with heart disease.2In