ABSTRACT
There are two types of cardiac disease: congenital and acquired. Maternal deaths from acquired disease are much higher in the UK. Both may be undiagnosed, but, if known about, a referral to a cardiologist is necessary. Advances in medical/surgical treatment have allowed more women with pre-existing cardiac conditions to embark on pregnancy. Physiological pregnancy adaptations are usually well-tolerated; however, if there is underlying cardiac disease, the increase in cardiac output may have a profound effect. Predisposing and/or risk factors are usually identified at booking by the midwife, and the knowledge of these can underpin suspicion of heart involvement if the woman presents with symptoms. Bacterial endocarditis and myocarditis may occur when there is damage to the cardiovascular system from any cause, and it has been suggested that these conditions should always be considered when a cause of pyrexia is not immediately obvious.
