Book Review

Heart Disease in Pregnancy

N Engl J Med 2008; 358:2529-2530June 5, 2008

Article

Heart Disease in Pregnancy
Second edition. Edited by Celia Oakley and Carole A. Warnes. 354 pp., illustrated. Oxford, England, Blackwell/BMJ Books, 2007. $121.95. ISBN: 978-1-4051-3488-0

Cardiac problems in pregnancy present a challenge to pregnant women and their physicians. Because of the relative rarity of heart disease in young women, most clinicians do not acquire sufficient experience in the management of such conditions. And because pregnant women are usually excluded from clinical trials, the efficacy and safety of most diagnostic procedures and therapeutic interventions have not been adequately tested. The available information is therefore mostly anecdotal. A comprehensive review of the literature by clinicians with experience in the management of pregnant women with cardiac problems would be useful.

The editors of the second edition of Heart Disease in Pregnancy are clinicians and investigators who have devoted a substantial part of their long careers to studying and treating pregnant women with cardiac problems. The book contains 23 chapters, written by the editors and their contributors — 30 other experts from North America and Europe. It begins with descriptions of the physiological changes in pregnancy and the cardiovascular examination of a normal pregnant woman, and it goes on to cover all acquired and congenital cardiovascular diseases. In addition, the book includes chapters on pulmonary hypertension and pulmonary embolism, the management of labor and delivery, anesthesia in high-risk patients with heart disease, genetic counseling, and recommendations for contraception for the patient with heart disease.

The book is generally well written and easy to read, and many of the chapters provide a summary and notes that are practical and easy to follow and remember. The editors and authors should be congratulated for producing an excellent book that should be extremely helpful to any clinician who is challenged by the management of heart disease in a pregnant woman.

Uri Elkayam, M.D.
University of Southern California, Los Angeles, CA 90033
elkayam@usc.edu