Heart Care for New Moms and Moms-to-Be
For pregnant women, the symptoms of heart problems may be indistinguishable from all the other physical changes she undergoes. Shortness of breath, swelling, hypertension, an increased heart rate—all these can be common during pregnancy.
But if these symptoms become pronounced—if swelling is significant, breathing difficulties happen when lying down or shortness of breath comes with a new cough, chest pains or a racing heart—it’s time to seek advice from your doctor, says Kathryn Lindley, MD, Washington University cardiologist at Barnes-Jewish Hospital.
Dr. Lindley heads an innovative maternal cardiac management program that offers an experienced team adept at monitoring and treating cardiac problems in pregnant and postpartum women. “If symptoms are apparent, see your obstetrician/gynecologist first to be evaluated, and then he or she will consult with a cardiologist. We want to identify the problem as soon as possible to begin a treatment plan.”
The maternal cardiac care team treats pregnant and postpartum women with heart failure, aortic and other valve problems, complex congenital heart defects, arrhythmias and severe preeclampsia. Throughout each stage of pregnancy, delivery and postpartum, the team consults regularly with the patient’s obstetrician/gynecologist and maternal-fetal medicine obstetricians, who specialize in high-risk pregnancies.
Although only 1 to 2 percent of expectant mothers currently have or will develop heart disease, it is the most common cause of death in pregnant women. Maternal heart problems can also cause decreased blood flow to the placenta, preterm birth, low birth weight and other complications during pregnancy and birth.
Before becoming pregnant, women with pre-existing heart conditions should be seen by their cardiologist —even before stopping birth control, says Lindley. “And if a woman with a heart condition experiences an unplanned pregnancy, we recommend she make an appointment with us as soon as her pregnancy is confirmed.” The maternal cardiac team monitors all its patients closely during the first trimester to track progress and to schedule any interventions that will help ensure a safe and healthy delivery.
Early diagnosis is key for women who develop heart problems after becoming pregnant. Though symptoms of cardiomyopathy (heart disease) usually first appear midway through the pregnancy, they can appear at the end of the last trimester or during the first several months after delivery. Lindley advises that new moms with heart conditions, or those who suddenly develop heart issues, watch for the onset of new symptoms like faintness, palpitations or shortness of breath and contact their doctor right away.
Although uncommon, peripartum cardiomyopathy is a serious illness that can cause an enlarged or weakened heart in a woman with no known heart disease prior to or during her pregnancy. “While only 1 in 2,000 women will develop peripartum cardiomyopathy, once it occurs, there is a 50 percent chance of recurrence in subsequent pregnancies and an increased potential for heart failure in the future,” Lindley says.
The team has dealt with all types of maternal cardiac complications at various stages of pregnancy and postpartum, she adds. “We take satisfaction in helping moms deliver babies safely and enjoy their growing families.”
Category: Heart & Vascular