Cardiomyopathies, heart failure, and pregnancy

Abstract

Women with cardiomyopathy are at risk for complications during and after pregnancy if they are unable to adapt to the hemodynamic changes of pregnancy. The hemodynamic challenges of pregnancy, labor, and delivery pose unique risks to this group of patients which can result in clinical decompensation with overt heart failure, arrhythmias, and even maternal death. A multidisciplinary approach and a controlled delivery are crucial to adequate management of patients with underlying heart disease. Preconception planning, proper counseling, and accurate risk assessment are essential and should be offered to women of childbearing age. In this chapter, the risk assessment of pregnancy in women with cardiomyopathy will be reviewed. In addition, the management of pregnant women with cardiomyopathies and heart failure will be discussed including consideration of issues at the time of labor and delivery.