Maternal Heart Disease in Pregnancy

Heart disease may be present in as many as 4% of parturients, and a mortality rate as high as 6.8% in NYHA class III-IV patients. NYHA class I-II patients (asymptomatic, or slight activity limitations), by contrast, have a mortality rate < 1%. The most dangerous abnormality is pulmonary hypertension, followed by mitral stenosis combined with a-fib, tetraology, Marfan’s, and coarctation of the aorta. Particularly dangerous for these patients are the risks that accompany the massively increased cardiac index that occurs after delivery.