Cardiovascular Complications in Pregnancy

Purpose of review: We review the epidemiology, risk factors, presentation, pathophysiology, diagnosis, peripartum management, and postpartum follow-up of chronic hypertension, hyperlipidemia, acute myocardial infarction, stroke, heart failure, pulmonary embolism, and atrial fibrillation. Recent findings: We discuss pathophysiology and evidence-based management for chronic hypertension, hyperlipidemia, acute myocardial infarction, stroke, heart failure, pulmonary embolism, and atrial fibrillation. Summary: It is essential for providers and patients to understand how cardiovascular diseases cause complications in pregnancy and to identify when patients require screening before conception and throughout the pregnancy. While primary care physicians, obstetricians, and cardiologists, should all have a general understanding of cardiovascular diseases during pregnancy, for higher risk patients it is important to create a multi-disciplinary cardio-obstetrics team for preconception planning, and for risk reduction during and after pregnancy. Shared decision-making regarding risks and benefits is crucial to improve maternal morbidity and mortality in the United States.