BMJ  2007;335:1042-1045 (17 November), doi:10.1136/bmj.39365.655833.AE

Practice

Pregnancy Plus

Valvular heart disease

E Gelson, clinical research fellow1, M Gatzoulis, professor of cardiology2, M Johnson, reader in obstetrics and obstetric medicine1

1 Academic Department of Obstetrics and Gynaecology, Imperial College London, London SW10 9NH , 2 Adult Congenital Heart Centre, National Heart and Lung Institute, Royal Brompton Hospital, London SW3 6NP

Correspondence to: E Gelson egelson@imperial.ac.uk

Valvular disease may be unmasked in pregnancy when physiological changes increase demands on the heart. Women with valvular heart disease require close follow-up during pregnancy, delivery, and postpartum

The first 150 words of the full text of this article appear below.

Introduction

Valvular heart disease in pregnancy is rare, but it significantly increases maternal and fetal risk. Despite an overall decline in the incidence of rheumatic heart disease in Europe and North America,1 worldwide rheumatic mitral stenosis is the most common valvular lesion in pregnancy.w1 With changing patterns of immigration, rheumatic heart disease may well become a serious problem in the United Kingdom. Advances in cardiac medication and surgery mean that more women with congenital valvular disease survive into adulthood and reproductive maturity.

Valvular heart disease may present for the first time in pregnancy as the increasing demands on the heart lead to decompensation and cardiac failure. However, the diagnosis is not always easy as the symptoms of pregnancy (tiredness, shortness of breath, and palpitations) can mask those of deteriorating disease. Moreover, in the United Kingdom, a decline in rheumatic fever means that valvular heart disease is now rare, and doctors—particularly general . . . [Full text of this article]

Does pregnancy affect valvular heart disease?

Does valvular heart disease affect pregnancy?

How is pregnancy managed?

Symptoms
Signs
No allergy to penicillin
Allergy to penicillin

Follow-up

Conclusion


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Rapid Responses:

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