[How to manage pregnancy in cardiac patients]

An increasing number of women with cardiac disease come up with the idea of becoming pregnant. Immigrants are frequently affected by valvular heart disease. Recently, arrhythmias, high blood pressure and ischemic heart disease affect many less-young pregnant women. Finally, grown-up patients with congenital heart disease have now entered their fertility period (particularly following the Fontan operation). Pregnancy is legitimate and frequently cannot be restrained; it calls for a careful evaluation of all its treatment aspects by a multidisciplinary team and the cardiologist role is of the utmost importance. A few conditions make pregnancy a hazard to both mother and fetus: pulmonary hypertension, left ventricular failure, left-heart obstruction, Marfan syndrome with aortic dilatation, and cyanosis. Most remaining cases are compatible with an (almost) normal course whereby mothers can be reassured. However, all items covered by guidelines should be met, according to the quality imperative.