Your heart works extra hard during pregnancy, with an increased heart rate, lower blood pressure and up to 50 percent higher blood volume to feed the needs of your developing baby. During labor and after delivery there are additional fluctuations in blood flow, heart rate and blood pressure. It can take several weeks before your heart returns to pre-pregnancy normal.
It’s understandable that a heart condition can complicate your pregnancy. If you have cardiovascular disease, a Women’s Heart Wellness Program cardiologist will work with your obstetrician to evaluate potential risks and provide special care to ensure the safety of both you and your baby.
There are many cardiovascular conditions that can have serious effects on pregnancy. Some common ones are congenital heart disease (heart defect that you are born with) or rheumatic valve disease (from untreated strep throat leading to rheumatic fever). History of a mechanical heart valve and the use of blood thinners also may affect pregnancy. Sometimes there are conditions that develop during pregnancy, such as, preeclampsia (elevated blood pressure) or peripartum cardiomyopathy. All of these conditions requiring different types of monitoring and treatment to help ensure both the mother and the baby do well throughout the pregnancy, delivery and after
Your Heart Condition and Pregnancy
If you were born with a heart problem, your baby is also at risk of developing a heart defect.
Here are two examples off congenital heart defects:
- Atrial septal defect: A hole in the wall separating the two upper chambers of your heart.
- Ventricular septal defect: A hole in the wall separating the two lower chambers of the heart.
Other conditions, not congenital, that can complicate a pregnancy:
Signs of Heart Disease During and After Pregnancy
Heart disease is the leading cause of the death in the United States among women who are pregnant or recently gave birth (the postpartum period).
Some symptoms to watch for during that time:
- Extreme swelling
- Unusual weight gain
- Extreme fatigue
- Chronic cough
- Fainting
- Shortness of breath
- Chest pain
- Abnormal heartbeat
A cardiologist, as part of your multidisciplinary team , can guide you through your pregnancy, and beyond, often with medication, dietary changes or exercise. They will also work closely with your primary team, primary cardiologist, and delivery team.
Here’s an example. A report in Circulation, the American Heart Association’s journal, indicated pregnant women with preeclampsia, a high blood pressure disorder, have a 71 percent higher risk of dying from heart disease or stroke in their lifetime. How can you prevent preeclampsia? While it can’t always be prevented, we know that a healthy diet, low in salt and regular exercise during pregnancy can help.
It is important to get regular prenatal checks with your obstetrician, because if preeclampsia is caught early, with close monitoring and appropriate treatment, most women with preeclampsia can deliver a healthy baby.
Monitoring Your Condition
Prenatal care includes regular checks of your weight and blood pressure, possibly supplemented with blood and urine tests. Every patient is different, so your Women’s Heart Wellness Program cardiologist will let you know how often you will be seen and if or when special tests need to be done.
Here are two common types of tests that can give your cardiologist a clearer picture of how your heart is working:
- Echocardiogram: Ultrasound waves produce images of your heart to give more information about how the heart is pumping and how the valves are working. It is similar to the ultrasound you might have of the baby, but this one is for the heart.
- Electrocardiogram: Also known as an EKG (or ECG), this test records the electrical activity that travels through the heart with each beat.
If you are unsure if you need to see a cardiologist prior to conceiving, during, or after your pregnancy speak with your OB. If you feel that something is wrong please call 911 and seek emergent medical attention.