Pregnancy and Heart Disease

Pregnant women are especially vulnerable to a variety of medical conditions and issues that can threaten their and their children’s lives. Pregnancy is like a physiologic stress test for woman’s heart and circulatory systems; it can pose serious risks not only for the approaching birth but also cause serious long-term complications for the mother. Even healthy mothers can experience heart problems during pregnancy.

During pregnancy, a woman’s blood volume typically increases from 30% to 50%, all in order to provide nourishment for the growing fetus. However, as blood volume increases, so does the amount of work the heart has to perform. A pregnant woman’s heart has to exert twice as much effort to circulate the increased blood volume.

During labor and delivery, blood pressure and heart rate can drastically change, putting additional strain on the heart muscle. After the birth of the baby, the heart muscle can be stressed as extra volume returns to circulation from placenta and reabsorbs from the body.

Women with pre-existing heart disease may experience worsening in their condition and have more severe signs and symptoms at any time during pregnancy, labor, delivery, and postpartum. Cardiac complications may manifest themselves at any time during a pregnancy or within a year after what seemed to be a normal pregnancy.

Causes of Heart Disease During Pregnancy

A pregnant woman’s body undergoes a variety of changes to ensure the safety, comfort, and nutrition of the baby inside her. The cardiovascular system is one of the organ systems that undergo many changes, which in turn can affect the individual’s cardiovascular and general health. The changes in the woman’s circulatory and cardiovascular systems begin in her first trimester; typically peaking during the second, plateauing in the third trimester, before normalizing or disappearing during year after the baby is born. Some of the risk factors for developing heart disease during pregnancy include:

Non-modifiable risk factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing heart disease.

Modifiable risk factors: These factors can be modified, treated or controlled through medications or lifestyle changes.

  • Alcohol and/or drug abuse during pregnancy
  • Obesity or having a body mass index “BMI” of 30 or greater.
  • Poor nutrition before and during the pregnancy
  • Diabetes: when your blood glucose, also called blood sugar, is too high.
  • High blood pressure

Symptoms of Heart Disease During Pregnancy

Heart disease during pregnancy can cause the following signs and symptoms:

  • Chest pain
  • Lightheadedness/Fainting
  • Fatigue
  • Rapid heart rate (tachycardia) of more than 100 beats per minute.
  • Increased need to urinate at night
  • Persistent cough
  • Severe shortness of breath
  • Swelling of feet, hands, ankles, and arms

Diagnosis of Heart Disease During Pregnancy

To diagnose heart problems, your doctor will take a careful medical history, review your symptoms and perform a physical examination. To find out how your heart condition is affecting your pregnancy, your doctor may do the following:

Diagnostic tests and procedures

*Additional testing may be required after pregnancy

Treatment of Heart Disease During Pregnancy

Treatment for heart disease during pregnancy involves a balance of the right lifestyle changes, and in some cases, medications. Treatment options include:

Lifestyle changes

Medication you take during pregnancy can affect your baby. Often the benefits outweigh the risks, however. If you need medication to control your heart condition, your health care provider will prescribe the safest medication at the most appropriate dose. Take the medication exactly as prescribed. Don't stop taking the medication or adjust the dose on your own.