JAMA. 1922;79(11):893-895. doi:10.1001/jama.1922.02640110033009.
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The subject of marriage in girls, and pregnancy, in women with cardiac disease is naturally of vital interest from the standpoint of the obstetrician, the general practitioner and the cardiologist.

With reference to marriage in girls with valvular disease, views vary from the extremely narrow one of absolute interdiction in those with any type of heart trouble to the physician's consent to marriage in those with even advanced heart disease. Marriage (without pregnancy) has as its chief dangers the excitement and heart strain incidental to coitus. That this can be a real danger is shown by occasional instances of hemoptysis immediately following coitus in those with mitral stenosis. In those with a tendency to or with actual tachycardia without decompensation, the sexual act may induce or continue a cardiac neurosis superadded on an actual organic lesion. While there is no invariable rule, marriage should not be advised in those who


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