Primary care physicians have an important role in timely diagnosis and appropriate treatment of gravid patients with cardiac disorders. Health of the mother and child can be optimized with thorough understanding of the pathophysiology of cardiac disorders during pregnancy, especially those with potentially serious effects, such as peripartum cardiomyopathy and acute myocardial infarction. Mitral stenosis often manifests for the first time during pregnancy. Mitral valve prolapse is usually benign but in some cases necessitates antibiotic prophylaxis for delivery. Pregnancy in women with prosthetic cardiac valves may expose mother and child to risks that can be minimized with appropriate safeguards.