Feature Article

Pregnancy and heart disease

Lisa Ann Simmons



The substantial cardiovascular adaptation that occurs during normal pregnancy may precipitate the first presentation of heart disease. A multidisciplinary approach comprising GPs, obstetricians, cardiologists, cardiac anaesthetists and neonatologists is required for the optimal management of pregnancy in women with heart disease.

Key Points

  • Pregnancy is associated with major physiological changes resulting in an augmentation of cardiac output of 40 to 50% by the end of the second trimester.
  • Women with pre-existing heart disease who are unable to compensate for increased cardiac demand may present with an exacerbation of their heart disease during pregnancy.
  • Valvular heart disease, arrhythmias and congenital heart disease are the major cardiac abnormalities encountered during pregnancy in antenatal clinics.
  • GPs caring for women peripartum are often the first to document a murmur or arrhythmia and determine the need for further investigation.
  • Optimal management of pregnancy in women with heart disease can be achieved in antenatal clinics utilising a multidisciplinary team.