This study protocol employs a prospective cohort design. A group of woman with a history of cardiac disease and pregnancy will be identified as potential subjects for a study cohort. Each potential subject will have an initial assessment of her cardiac history, condition, and functional status. A detailed review of her complete medical, surgical, gynecologic, and obstetrical history will be obtained as dictated by standard care. Appropriate management for each potential subject's medical and obstetrical care will be initiated and undertaken by accepted clinical practice. Potential subjects for this cohort will be obstetrical patients either cared for directly by or in consultation with the Regional Perinatal Center, Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, SUNY Upstate Medical University.