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The importance of pre-pregnancy counselling in cardiac disease

March 2014 Br J Cardiol 2014;21:22–8 doi:10.5837/bjc.2014.004

The importance of pre-pregnancy counselling in cardiac disease

P Rachael James

Abstract

Introduction Women with cardiac disease are at increased risk during pregnancy due, in part, to the volume loading and increased cardiac output associated with normal pregnancy. Any haemodynamic changes are magnified in the case of a multiple pregnancy. It is essential that any woman with acquired or congenital heart disease, or those at increased risk, e.g. an adult survivor of childhood cancer who may have subclinical left ventricular dysfunction, be seen for pre-pregnancy counselling to quantify their risk and optimise their cardiac state prior to conception. Deaths from cardiac disease in pregnancy are increasing, and cardiac disease rem

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