Expecting a baby is one of the happiest times of your life. But at the same time, your body is going through a lot of changes. With these changes, you can sometimes feel a little scared, especially when it comes to heart problems. Many people are unnecessarily scared because they don't know much about this. So, today we'll talk about everything you need to know about heart disease during pregnancy, simply and clearly.
What is cardiac disease during pregnancy?
Simply put, any problem that affects your heart during pregnancy falls into this category. This can happen in two main ways.
1. Pre-existing heart conditions: This refers to heart conditions that you had before you became pregnant. These may not have caused you any symptoms or major problems before. However, with the changes that occur in your body during pregnancy, these conditions can affect you differently and cause complications.
2. New-onset heart disease during pregnancy: These are conditions that you didn't have before you got pregnant and that develop during this time. While some of these are harmless, some can be dangerous.
The important thing is that most women with heart disease can safely get pregnant and give birth to a healthy baby, but it requires proper medical advice and supervision.
However, sometimes this condition can lead to serious complications. In fact, in countries like the United States, cardiovascular disease is the leading cause of maternal deaths.
- 1 in 3 pregnancy-related deaths are due to heart disease.
- Heart disease affects about 4 out of 100 pregnancies.
- Factors such as high blood pressure, obesity (increased body weight), and being over 40 years old further increase this risk.
Don't be afraid to learn these things. These are things to make you aware. If you are pregnant or planning to get pregnant, it is very important to be aware of this. Before that, let's understand what happens to your heart and blood vessels during pregnancy.
What happens to your heart and blood vessels during pregnancy?
Your body is going through a lot of amazing changes during this time. These changes put extra pressure on your body and your heart has to work harder than usual. These changes are normal. They are to ensure that the baby growing in the womb gets the right amount of oxygen and nutrients.
- Increased blood volume: Your body's blood volume starts to increase from the first few weeks of pregnancy. By the end of pregnancy, your blood volume has increased by about 40% - 45%. Remember, this is because your blood supply needs to be increased along with your baby.
- Increased heart rate: It is normal for your heart rate to increase by about 10-20 beats per minute during this time. This gradually increases, reaching its peak during the third trimester.
- Cardiac Output: This is the amount of blood your heart pumps per minute. This can increase by 30% to 50% between weeks 28 and 34. If you are carrying twins, this can increase by up to 60%.
These changes may make you feel things like:
- Feeling unbearably tired (Fatigue).
- Feeling dizzy.
- Difficulty breathing, feeling like you're suffocating (Dyspnea).
- Palpitations (feeling like your heart is beating fast).
Here's where it gets a little confusing. These symptoms are common during pregnancy. However, these same symptoms can also be signs of heart disease . So, even though you have the warning signs of heart disease, you might think, "Oh, this is just something to do with pregnancy." That's why heart disease during pregnancy is so dangerous. It can be hard to tell if a symptom is normal or something to be concerned about.
If you have pre-existing heart disease, you are at higher risk of complications during pregnancy. This risk depends on the type of condition you have and its severity.
What if you have a pre-existing heart condition?
Some heart conditions are associated with an increased risk of complications during pregnancy. If you have any of the conditions listed below, it is important to discuss the risks with your doctor before getting pregnant.
Congenital Heart Disease
These are problems with your heart that you have at birth. Some of these can be minor, while others can be very serious. Children with serious conditions are usually treated when they are young. But sometimes the heart can still function differently after surgery.
So if you have a congenital heart condition, definitely talk to your doctor before getting pregnant. He or she will refer you to a cardiologist. They will assess your pregnancy risk and give you the necessary advice.
The most common complications in pregnant women with congenital heart disease are:
- Abnormal heartbeat (Arrhythmia)
- Heart Failure
- Fetal malformation or premature birth
Low-risk situations:
- Mild pulmonary valve stenosis.
- Successfully treated "holes in the heart" - (Atrial Septal Defects - ASDs) and (Ventricular Septal Defects - VSDs).
- Successfully treated (Patent Ductus Arteriosus - PDA).
High-risk situations:
- Aortic valve stenosis with a bicuspid aortic valve.
- Coarctation of the aorta.
- Tetralogy of Fallot (treated).
- Transposition of the great arteries (treated).
There are many other congenital heart diseases that are not on this list. Even if your condition is not listed here, it is important to talk to your doctor if you are thinking about getting pregnant.
Cardiomyopathy
Cardiomyopathy is a leading cause of serious complications and death during pregnancy. The risk depends on the type you have and its severity. If you have this condition, talk about the risks before getting pregnant.
Heart Valve Disease
There are many types of heart valve disease that can occur during your lifetime. Some minor valve diseases do not affect pregnancy, while some serious conditions increase the risk. If you have a history of valve disease, ask your doctor if it is safe to get pregnant.
Some women may have a prosthetic heart valve. They need special care during pregnancy. This is because the risk of blood clots is higher during pregnancy. Also, having a prosthetic valve increases that risk even more. Some blood thinners (anticoagulants) taken for this can be harmful to the baby. Therefore, if you have a prosthetic valve, be sure to see a cardiologist before planning to get pregnant.
What new heart diseases can occur during pregnancy?
Even if you have no previous heart disease, you may develop new heart or blood vessel problems during pregnancy. Let's take a look at what they are.
| Medical condition | Simple explanation |
|---|---|
| High blood pressure (Hypertension) | It affects about 1 in 10 pregnant women. There are several types: - Gestational hypertension: High blood pressure that begins after 20 weeks. - Preeclampsia: High blood pressure, protein in the urine, or damage to other organs. If this is accompanied by seizures, it is called Eclampsia . - Chronic hypertension: High blood pressure that has been present since before pregnancy. |
| Gestational Diabetes | High blood sugar levels that occur after 20 weeks of pregnancy. If left untreated, complications can occur for both mother and baby. |
| Abnormal heartbeats (Arrhythmias) | Heart rhythm disorders. The most common is a condition called supraventricular tachycardia (SVT) . |
| Spontaneous coronary artery dissection (SCAD) | This is a life-threatening emergency where the wall of an artery supplying blood to the heart tears. It usually occurs within a week of giving birth. |
| Peripartum Cardiomyopathy | A type of heart failure that occurs late in pregnancy or shortly after childbirth. It occurs in women who do not have previous heart disease. |
| Blood clots (DVT and Pulmonary Embolism) | During pregnancy, there is an increased risk of blood clots (Deep Vein Thrombosis - DVT) in the deep veins of the body (usually in the legs). If this blood clot travels to the lungs, it is called (Pulmonary Embolism - PE) . This is a very dangerous condition. |
How to recognize the symptoms of heart disease?
As we discussed earlier, some heart disease symptoms are very similar to normal pregnancy symptoms, so it's important to distinguish between the two.
| Common symptoms during pregnancy | Warning signs that may indicate a heart attack |
|---|---|
| - Excessive fatigue - Frequent urination - Slight shortness of breath - Swelling of the legs and ankles (Edema) | - Difficulty breathing even at rest - Difficulty breathing that wakes you up at night - Palpitations lasting more than 30 seconds - Fainting - Chest pain or tightness - Blurred vision |
Extremely important: If you experience chest pain or discomfort , do not ignore it. Call 911 immediately or go to the Emergency Department (ETU) of the nearest hospital. Quick action at a time like this can save a life.
Tell your doctor about all the symptoms you experience. It would be great if you could write these things down in a book.
- The symptom you are feeling.
- Date and time.
- Its severity (on a scale of 1-10).
- What you were doing at the time (e.g., exercising, doing homework, relaxing).
How to manage heart disease during pregnancy?
Heart disease during pregnancy can be managed with proper medical treatment and self-care on your part. Here are some things you can do:
- Don't miss medical appointments: You will need to be monitored by both an obstetrician and a cardiologist. Don't miss any appointments. You will need to have regular tests (echocardiograms) to check how your heart is working.
- Avoid excessive weight gain: Ask your doctor about how much weight you can safely gain during pregnancy.
- Avoid stress: Stay away from things that bother you as much as possible. Find ways to calm your mind. If your doctor allows it, things like prenatal yoga can be helpful.
- Eat a heart-healthy diet: Consult your doctor about what foods to eat and what not to eat. In general, reduce salt, sugar, saturated fat, and trans fat.
- Exercise safely: Ask your doctor about the types of exercise that are right for you and how often you should do them. You should avoid activities that put too much strain on your heart.
Medications during pregnancy
Taking your prescribed medications as prescribed is an important part of your management plan. Some heart medications are not safe during pregnancy, so your doctor may make changes to your medications.
Some types of medications that are not safe during pregnancy:
- (ACE inhibitors)
- (Angiotensin receptor blockers - ARBs)
- (Aldosterone antagonists)
- Some blood thinners, such as Warfarin
The most important thing is, do not stop or start any medication without talking to your doctor. If you find out you are pregnant while taking one of these medications, call your doctor immediately.
Think about your health after having a baby and also about your future health.
Some complications can occur up to six months after the baby is born. Therefore, medical supervision is very important even after childbirth. Even if you are very busy or tired during this time, do not miss the days when you are supposed to see the doctor.
Having heart disease or a related condition such as preeclampsia or gestational diabetes during pregnancy increases your risk of developing cardiovascular disease in the future.
- Gestational diabetes increases the risk of future heart disease by 68%.
- Gestational hypertension increases the risk of heart disease in the future by 67%.
- Preeclampsia increases the risk of dying from heart disease in the future by 75%.
Don't be alarmed by these numbers. Think of them as a warning sign. Use this knowledge to take steps to protect yourself from heart disease in the future. If you have had a similar situation, talk to your doctor after you have your baby and get screened for heart disease. By making lifestyle changes and, if necessary, continuing to see a cardiologist, you can stay healthy in the long run.
If you have heart disease and are planning to get pregnant, talk to your doctor now. Learn about the risks and how to manage your condition during pregnancy. Even if you don't have heart disease, it's important to be aware of unexpected heart problems. By talking to your doctor, reducing your risk factors, and having a safe and healthy pregnancy, you can help prevent heart disease.
Take-Home Message
- Pregnancy is a time when your heart is under extra strain. That's normal.
- Symptoms such as fatigue and nausea that are common during pregnancy can sometimes be signs of heart disease. Be aware of this.
- If you have a pre-existing heart condition, be sure to consult a cardiologist before getting pregnant.
- Treat chest pain, loss of consciousness, and severe shortness of breath even at rest as emergencies . Go to a hospital's Emergency Department (ETU) immediately.
- Do not start or stop any medication without your doctor's advice.
- Even after having a baby, think about your health. Don't miss scheduled medical checkups.
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