A 32-year-old woman with a history of congenital heart disease is planning to start a family. She has no other significant medical history and is currently symptomatically stable on a small dose of loop diuretic.
Question
Which one of the following conditions is associated with an unacceptably high risk in pregnancy?
A Corrected tetralogy of Fallot
B Perimembranous ventricular septal defect
C Secundum atrial septal defect
D Coarctation of the aorta
E Pulmonary hypertension of any cause
Answer:
E. Pulmonary hypertension of any cause
Other high-risk cardiac conditions are
severe mitral, pulmonary or aortic stenosis and
Marfan’s syndrome with a dilated aortic root.
Intracardiac shunts without pulmonary hypertension are relatively safe but require closer follow-up.
Operated tetralogy of Fallot without residual pulmonary stenosis is lower risk.
Coarctation is associated with dissection and is intermediate risk.
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