Abstract
This chapter focuses on the precarious interaction between cardiac disease and pregnancy. Maternal outcome in the cardiac patient depends on the type of cardiac disease, ventricular function, maternal functional status, presence and severity of cyanosis, pulmonary vascular disease, and prior surgical procedures, along with any uncorrected lesions and sequelae of the repair itself. The relative frequency of congenital versus acquired heart disease is changing. Secundum atrial septal defect (ASD) is the most common repaired and unrepaired congenital lesion that occurs in pregnant women. Women with secundum ASD rarely manifest pulmonary hypertension in the childbearing age range. A patent foramen ovale or ASD may be present in the interatrial septum, and thus, these patients may have a noncyanotic or cyanotic form of Ebstein anomaly. Maternal wellbeing is rarely significantly affected by pulmonic stenosis. Congenital and rheumatic aortic valvular disease are important causes of aortic stenosis.