Pregnancy and Heart Disease

Any woman suffering from some form of heart ailment should first discuss her condition with her health care provider before she decides to conceive and become pregnant. There is an average global figure of 1% pregnant women, who suffer from some form of heart disease during their pregnancy. The chances that women with congenital heart disease giving birth to a child with the same type of heart defect are very strong. A woman with heart problem needs special care during pregnancy and delivery to avoid any sort of complications. Even normal women may face some sort of heart problems during pregnancy because pregnancy places an increased demand on the heart. Some gestational heart problems include peripatum cardiomyopathy, hypertension, preeclampsia , blood clots, and others.

Heart diseases are very scary and are the third highest cause of death in women during or soon after pregnancy. They can also affect the fetus. The child in the womb does not develop properly and may not even survive the pregnancy and delivery process. Congenital heart defects that may develop in the fetus include abnormalities in the structure of the heart chambers and valves and also the vessels that carry blood to and from the heart. Heart diseases create complications for about 1-4% normal women without any pre existing cardiac abnormalities during pregnancy.

The heart is the hardest working muscle in the body and there is an increase in the volume of blood as the pregnancy progresses. During the first trimester, the blood increase to approximately 50 pecent more than normal and there is extra load on the heart. The pain, pressure and the force exerted during labor and subsequent delivery causes changes in the heart and vascular system. The contractions in the uterus moves a lot of blood from there and can cause the heart beat rate, the blood pressure, and the cardiac results to change and become high. Post delivery, again there are a number of changes in the heart beat and blood pressure because of extreme blood loss due to which the heart slows down .

Pregnant woman with heart problems show the following symptoms –

  • Palpitations
  • Difficulty in breathing
  • Dizziness and exhaustion
  • Heart murmur
  • The coloring of a person is blue because of low levels of oxygen in the blood called cyanosis
  • Enlarged heart

A heart disese symptom should not be ignored and a physician should be consulted for diagnosis. After a thorough examination of physical and medical history, the physician may recommend an ECG (Electrocardiogram) test and an Echocardiography test.

Some common cardiac problems during pregnancy are –

  • Mitral stenosis (MS) –  In this condition, a throat virus called streptococcus causes the heart valve between the left atrium and left ventricleis to narrow. This causes a pregnant woman suffer from problems such as irregular heartbeat, lung congestion, and  difficult breathing. Woman under such conditions need medication to regularise their heart and may also need some surgery involving the valve during pregnancy. Also during labor and delivery the heart and the pressure within the heart needs to be monitored invasively.
  • Ventrlcular septal defect (VSD) – In this condition, a malfromed and deformed opening between the right and the left ventricle leads to an out of control blood flow from the heart. The heart enlarges because it overworked. This VSD can pass on from the mother to the child.
  • Aortic stenois (AS) – In this condition, it becomes very difficult for the heart to supply blood to the whole body because the arotic valve between the left ventricle and the arota becomes very narrow and thin. A normal valve has three cusps where as a stenotic valve has only one or two. Women with serious Arotic stenosis are generally not advised to get pregnant because it may deteriorate the condition of the heart. In such cases invasive monitoring of the heart and the blood pressure is required. The patient under this condition is put on antibiotics to avoid any kind of infection.
  • Atrial septal defect (ASD) – In this condition, a deformed or out of shape opening between the two upper chambers of the heart causes a distorted blood flow through the heart. Pregnant women with this problem suffer from fatigue and no other serious complication arises but babies of such mothers may have the risk of getting this condition.
  • Mitral valve prolapse (MVP) –  In this condition, the mitral valves flaps (one or more) bulge during the heart contractions. The flaps do not close properly causing the blood to flow backward which results in a mitral regurgitation murmur. 12 percent of childbearing age women suffer from MVP but do not face any complications during pregnancy. Under this condition antibiotics need to be given during labor and delivery to prevent any kind of infection.

Women with heart diseases who get pregnant go through a lot of stress and tiredness due to all the physical changes in the body and their effect on the heart. They require an excellent prenatal care and a close watch to enable them to go through this period of challenges with good spirits and deliver a healthy baby froma healthy mother.

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