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Heart Disease in Pregnancy - The ProblemDateline: 07/19/98 Pregnancy is one of the physiological conditions that places a considerable burden on the heart, forcing it to work harder for a significantly long period - nine months. While a normal heart is quite capable of taking this extra workload right in its stride, a diseased one may not be able to cope. Different kinds of heart disease may cause different problems during pregnancy. In this series of articles I plan to discuss this topic in depth. The Problem While there is much regional variation in the incidence of heart disease in pregnancy (0.3 to 3.5 %), an average global figure is 1 %. This means almost one in every hundred women becoming pregnant will have some form of heart disease or the other ! Why is this so worrying ?
Which heart diseases are common during pregnancy ? Most heart diseases are present even before pregnancy, and become worse - or maybe manifest for the first time - only during gestation. Valvular heart disease leads the field, with mitral stenosis being the commonest lesion. Not many women with congenital heart disease became pregnant until recently. Today the commonest birth defects seen during pregnancy are patent ductus arteriosus, atrial septal defects and ventricular septal defects. Others like pulmonary valve stenosis, tetralogy of Fallot and coarctation of the aorta make up about 25%. In the near future, we may have to deal with a number of more complex conditions that have been treated surgically. Other heart diseases like coronary artery disease and rhythm disturbances are uncommon in the younger patients in the reproductive age group. Cardiomyopathy is another problem in pregnancy and will be discussed in detail later. In the next article, we will see how heart disease in pregnancy increases maternal and fetal risks. And don't forget. You can post your comments on this article on the Heart Disease Bulletin Board or discuss it in the Chat Room. You can also review articles in the following interest areas dealing with heart disease:
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