Inclusion Criteria:  Aged 18 and older Pregnant at any point in gestation (with singleton or multiple gestation)  History of congenital and/or acquired heart disease defined as the following:  valvular, congenital, ischemic heart disease or cardiomyopathy, clinically significant maternal arrhythmias in women, current or previous history of peripartum cardiomyopathy, supraventricular tachycardia, placement of either a pacemaker or electrical assist device, aortopathies (Marfan syndrome, Loey's Deitz, Ehlers Danlos [vascular subtype], pre-pregnancy diagnosis of pulmonary hypertension English- or Spanish-speaking  Exclusion Criteria:  Unable to provide written informed consent