ABSTRACT
Women with congenital heart disease make up an ever-increasing fraction of any adult cardiology practice for several reasons. First, congenital problems are increasing in prevalence. Though estimates vary considerably, current prevalence is 0.8%. Approximately 1600 patients with moderate to severe forms of congenital heart abnormalities in the UK enter adulthood each year,1 a conservative estimate according to the European Society of Cardiology.2 Second, diagnostic tools are more sophisticated and widely available, meaning that diagnoses are made earlier with better sensitivity and accuracy. Third, improved medical and surgical therapeutic options allow more patients to reach adulthood. Of children with congenital lesions, 77-90% will survive into maturity.3,4 Fourth, even though the above reasons apply equally to both genders, the female patients with congenital heart disease seek medical attention far more frequently because of pregnancy. Occasionally previously undiagnosed lesions are first discovered during antenatal visits. In high-risk pregnancy clinics in North America the majority of heart disease encountered will be congenital,5 although in developing countries rheumatic heart disease is still more common.6
