Use of Medication for Cardiovascular Disease During PregnancyJACC State-of-the-Art Review
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Author + information
- Dan G. Halpern, MDa,∗ (dan.halpern{at}nyumc.org), @nyulangone,
- Catherine R. Weinberg, MDa,
- Rebecca Pinnelas, MDa,
- Shilpi Mehta-Lee, MDb,
- Katherine E. Economy, MDc and
- Anne Marie Valente, MDd
- aAdult Congenital Heart Disease Program, Cardiology Division, NYU Langone Health, New York, New York
- bDivision of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, New York University Langone Health, New York, New York
- cPregnancy and Cardiovascular Disease Program, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- dBoston Adult Congenital Heart Disease Program, Boston Children’s Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- ↵∗Address for correspondence:
Dr. Dan G. Halpern, Adult Congenital Heart Disease Program, New York University School of Medicine, The Leon H. Charney Division of Cardiology, NYU Langone Health, 530 First Avenue, HCC building 7H, New York, New York 10016.
Central Illustration
Abstract
Cardiovascular disease complicating pregnancy is rising in prevalence secondary to advanced maternal age, cardiovascular risk factors, and the successful management of congenital heart disease conditions. The physiological changes of pregnancy may alter drug properties affecting both mother and fetus. Familiarity with both physiological and pharmacological attributes is key for the successful management of pregnant women with cardiac disease. This review summarizes the published data, available guidelines, and recommendations for use of cardiovascular medications during pregnancy. Care of the pregnant woman with cardiovascular disease requires a multidisciplinary team approach with members from cardiology, maternal fetal medicine, anesthesia, and nursing.
Footnotes
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received April 15, 2018.
- Revision received October 19, 2018.
- Accepted October 23, 2018.
- 2019 American College of Cardiology Foundation
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