Central hemodynamic changes associated with pregnancy in a long-term cardiac transplant recipient

We present a case of pregnancy in a woman who had undergone cardiac transplantation and was monitored by "surveillance" biopsy at intervals during the entire course of pregnancy and the immediate postpartum period. Exercise reserve remained normal during these periods despite angiographic evidence of coronary disease and episodes of rejection. Central hemodynamic changes were similar to those expected during normal pregnancy. Hemodynamic stability was maintained during epidural anesthesia for labor and subsequent cesarean section.