Clin Med
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Cardiac disease is the leading cause of maternal mortality in the UK. The major causes of cardiac deaths in pregnancy include cardiomyopathy, myocardial infarction, ischaemic heart disease and dissection of the thoracic aorta. With increasing numbers of migrant women in the UK, rheumatic heart disease in pregnancy has also re-emerged. ⋯ The care of pregnant women with heart disease thus requires a multidisciplinary approach, involving obstetricians, cardiologists and anaesthetists. This allows appropriate surveillance of maternal and fetal wellbeing, as well as planning and documentation of the management of elective and emergency delivery. This review discusses common cardiac conditions encountered in pregnancy and their antenatal and intrapartum management.
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Despite many advances in treatment, amyloid heart disease still portends a poor outcome. Around 50% of patients will suffer a sudden arrhythmic death. As in the case described, this may happen before the patient has received sufficient treatment to curtail the amyloidogenic process.
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Organ donation from deceased donors should occur whenever appropriate: that is, when there is evidence, belief or understanding that donation was the stated wish of the potential donor or would be in accordance with their wishes, is lawful and in line with current guidelines and will not add further distress to the family. This is the underlying assumption of the British Medical Association (BMA) report, National Institute for Health and Clinical Excellence (NICE) Guideline and Welsh Government Assembly Report. ⋯ Publication and adherence to guidelines that have clinical, legal and ethical validity will reassure the public. Organ donation not only improves the length and quality of life of recipients, but also saves resources for the NHS and provides benefit to the donor family.