The best method of curtailing the second stage of labour in heart disease is by:

Management of heart disease patient in 2nd stage: No maternal pushing and the tendency to delay in the second stage of labor is to be curtailed by forceps or ventouse under pudendal and/or perineal block anesthesia. Ventouse is preferable to forceps as it can be applied without putting the patient in lithotomy position (raising the legs increases the cardiac load).