Enfermedad cardíaca y embarazo

Heart disease complicates 1 to 4% of all pregnancies. During pregnancy there are important hemodynamic changes that can lead to decompensation in a patient with previous cardiac structural alteration. However, the majority of patients can have a successful pregnancy. The primary keys to managing these patients are: knowledge of the Anatomy of the disease, evaluation before pregnancy, identify the maternal-fetal risk, optimize hemodynamically the patient, use safe drugs at the lowest doses, genetic counseling and prognosis of the mother in the long term. Based on these points, it is important to make a management plan based upon the maternal and fetal risk, defining the frequency of clinical follow-up, specifically outlining the clinical routines, diagnostic imaging, laboratory exams, and possible timing and method of delivery. The management of patients should be multidisciplinary and those patients with increased risk, possibility of hemodynamic deterioration, or requiring some type of intervention, should be referred immediately to specialized centers with experience in caring for this type of patient.