Pregnant women are quite vulnerable to a number of medical conditions that not only threaten the life of the mother but that of the child too. The strain of pregnancy can put a lot of stress on the mother’s heart, which poses serious and severe long-term complications.

According to a study published in the journal of Cardiology and Therapy, the most common heart problems that cause complications during pregnancy include mitral or aortic stenosis (valve diseases), cardiac symptoms, systemic ventricular impairment, and cyanosis. However, women who have a mechanical valve placed in their heart are more at risk of anticoagulation (blood clots causing a heart attack).

Before we go into detail about these heart problems, let’s have a look at how pregnancy affects a woman’s heart:

Key Symptoms of Heart Disease in Pregnancy

• Faster heartbeat
• Palpitations
• Feeling tired from the start of the pregnancy
• Light-headedness
• Swelling of feet, ankles, arms, and hands, due to fluid retention
• Frequent urination
• Shortness of breath, even when not performing strenuous activities

Heart Condition during Pregnancy

Here’s what happens to a woman’s heart and its blood vessels in pregnancy:

• Blood Volume Increases: In the first trimester, blood levels in the body increase by 50% and remain high.
• Cardiac Output Increases: Cardiac output is the action of blood being pumped by your heart each minute. Since the volume of blood increases, so does cardiac output—by 40%!
• Heart Rate Increase: An increase in heart rate is completely normal. You will find that your heart beats 15 times more per minute.
• Blood Pressure Decreases: A decrease in blood pressure by 10 mmHg is fine. The change in blood pressure is due to two reasons — more blood flows towards your uterus and hormonal changes.

Keep in mind that these are the common changes that occur in every woman who goes through pregnancy. These changes ensure that the baby is getting enough nutrients and oxygen.

Now that you know the key symptoms of heart problems during pregnancy and how a heart works during this time, let’s talk about the complications.

Congenital Heart Conditions

Congenital heart conditions are related to blood clots, increase and decrease in blood flow, lesions, and problems with the aorta. Let’s have a look at them in detail.

Obstructive Lesions

Due to an obstructive lesion, the aorta narrows down and this reduces blood flow to the heart, as well as major blood vessels. In pregnant women, this increases the blood pressure, which prevents the placenta from receiving adequate blood.

Shunt Lesions

There are three types of shunt lesions, which include:

1. Atrial Septal Defect (ASD): A hole between your heart’s upper chambers
2. Ventricular Septal Defect (VSD): A hole between your heart’s lower chambers
3. Patent Ductus Arteriosus (PDA): Abnormal blood flow between the pulmonary artery and aorta

If the hole is too big, more blood will flow from your heart’s left side into its right side. Extra blood means that the heart will be forced to work harder to pump it back into the lungs. This causes a number of problems such as abnormal heart rhythms, enlarged heart, and pulmonary hypertension. As the blood flows in reverse, the level of oxygen supplied to the body decreases, which can lead to the baby and mother dying.

Complex Lesions

If a pregnant woman’s pulmonary arteries and aorta are attached wrong, surgery is required to prevent further problems. If the right ventricle starts to pump blood out of your body (a job that is done by the left ventricle) then this can result is leaky heart valves and heart failure.

Cyanotic Heart Disease 

Cyanotic Heart Disease involves a VSD that causes the pulmonary valve to narrow down. If the pulmonary valve starts to leak, it can cause heart rhythm disturbances and heart failure. It is important to get the surgery done before pregnancy or you will face severe complications.

Valve Disease

Mitral Valve Stenosis 

The valve linking the left ventricle and left atrium becomes narrow, which blocks blood flow to the heart. In pregnancy, this condition gets worse because blood flows at an increased rate. When the left atrium becomes bigger, it causes irregular heart rhythm that can lead to heart failure symptoms.

Aortic Valve Stenosis 

The valve between the aorta and the left ventricle becomes stiff, which forces the heart to work harder in order to pump a high volume of blood. Due to this, the left ventricle enlarges and causes heart failure. Women with aortic valve stenosis are recommended to get the surgery done before planning for pregnancy.

Treatment

While the course of treatment is different for every woman, there are a few precautions you can take to prevent your heart condition from worsening and affecting you and your baby:

• Avoid taking any kinds of drugs during pregnancy
• Opt for an epidural injection during labor
• Avoid stress
• Avoid gaining too much weight
• Get enough rest
• Schedule regular check-ups
• Manage anxiety (make preparations for everything so that you are not panicking at the last minute)

Two of the biggest concerns during pregnancy that women with heart diseases face are hypertension and Peripartum cardiomyopathy (develops in the last trimester of the pregnancy and its cause is known). Due to these two heart problems, a pregnant woman can quickly spiral towards a heart attack or stroke.

Most doctors recommend getting a thorough medical checkup before you start planning for pregnancy. While you can easily get pregnant with any one of the heart problems mentioned above, the changes in the heart can cause them to worsen. This will put too much strain on your heart, body, and the baby, and may even result in death.

If you are looking for a cardiologist to help you plan your pregnancy with your pre-existing heart condition, then visit Keystone Cardiovascular Center in Bergen County, New Jersey. Dr. Panagiotou is board certified in cardiovascular diseases and will help you find out whether you will be able to carry out a full term pregnancy. To know more about the services this center offers, visit their website or call on 201-882-6088.