| Category A Local Expertise | Category B Clinical review, advice and guidance from MMC | Category C Care led by MMC UCLH unless stated otherwise |
|---|---|---|
| Mild pulmonary stenosis | Mild reduced left ventricular ejection fraction (>45%) | Pulmonary hypertension: Pan London Pathway |
| Small/repaired patent ductus arteriosus | Hypertrophic cardiomyopathy with no high-risk features | Left ventricular ejection fraction <45% |
| Mitral valve prolapse with mild MR | Repaired aortic coarctation | Severe aortic stenosis |
| Repaired atrial septal defect | Mild mitral stenosis | Systemic right ventricle |
| Repaired ventricular septal defect | Moderate aortic stenosis | Fontan |
| Isolated atrial or ventricular ectopic beats | Other valve lesions not listed in A or C | Previous peripartum cardiomyopathy |
| Postural tachycardia syndrome (PoTS) | Atrioventricular septal defect | Ventricular arrhythmia |
| Mild aortic stenosis (peak AVG <36mmHG, peak velocity 2.6-2.9m/s, AVA >1.5cm2, normal LV function) | Repaired tetralogy of Fallot | Mechanical valve |
| Mild AR (PHT >500ms, normal LV function) | Supraventricular arrhythmias | Moderate-severe mitral stenosis |
| Turner syndrome without aortic Dilatation | Aortic dilatation | |
| Treated ischaemic heart disease | Heart transplant | |
| Myocarditis | New ischaemic heart disease | |
| Arterial switch repair of TGA | Inherited channelopathy | |
| Pacemaker in situ | Familial cardiomyopathy | |
| Implantable IED in situ |
Cardiac MDT – 1st Tuesday of the month between 1200-1300
The NCL cardiac MDT is held every 1st Tuesday of the month between 1200 and 1300 with multi-disciplinary presence including Cardiologists, Anaesthetists, Obstetricians, Obstetric Physicians and Midwives. Complex cardiology patients from across NCL can be discussed so that a comprehensive MDT maternity care plan can be made. To refer a patient to the MDT, please email….
Resources:
- ESC Guidelines for management of CVS diseases during pregnancy
- Expert consensus statement on the management of arrhythmias during pregnancy
- Intrapartum care guidelines cardiac disease
- Guidelines for the peri-operative management of people with cardiac implantable electronic devices: Guidelines from the British Heart Rhythm Society
- Contraception choices in women with cardiac disease