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Heart Disease and Pregnancy: Physiology and Management.

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Second edition. By Metcalfe James, McAnulty John H., Ueland Kent. . 432 pages. Little, Brown and Company; , Boston: , 1986., $70.00.

Ann Intern Med. 1987;106(5):787. doi:10.7326/0003-4819-106-5-787_2
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The pregnant patient poses a unique challenge to the internist or cardiologist. The presence of heart disease in a pregnant patient can be equally unsettling to a physician involved in obstetrics. Because the study of cardiac care in obstetrics has seen revolutionary changes since the books previous edition in 1958, the appearance of the second edition is timely.

The book includes a detailed review of the changes in cardiovascular physiology occurring in pregnancy, especially the vena cava obstruction by the gravid uterus and the hemodynamic effects of exercise. The comprehensive general evaluation of the pregnant patient shows how to select


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