Heart issues during pregnancy are referred to as cardiac illness in pregnancy. Pregnancy can present with two main categories of cardiac issues.
Heart issues that you had before getting pregnant are known as preexisting heart conditions. These diseases may not have shown any symptoms or serious side effects previously. However, they may impact you differently and cause issues if you are pregnant.
Pregnancy-related heart conditions: These are illnesses you didn't have before becoming pregnant. While some are safe, others may pose a threat.
The majority of women with heart issues during pregnancy are able to get pregnant and give birth to healthy children. However, heart illnesses can lead to major issues when pregnant.
Heart and blood vessels change during pregnancy
During pregnancy, your body goes through many changes. Your body is under more stress as a result of these changes, and your heart has to beat harder.
The changes listed below are normal during pregnancy. They aid in providing your developing fetus with adequate nutrition and oxygen.
Blood volume increase
During the first several weeks of pregnancy, your blood volume increases and stays elevated. The majority of pregnant women get a total increase in blood volume of 40% to 45%.
Heart rate increase
During pregnancy, it's common for your heart rate to rise by 10 to 20 beats per minute. It gradually increases during your pregnancy, reaching its peak by the third trimester.
Cardiac output increase
The volume of blood your heart pumps out in a minute is known as cardiac output. Your cardiac output may increase by 30% to 50% by 28 to 34 weeks.
The increased blood volume and quicker heart rate are the causes of this. Your cardiac output may rise by as much as 60% when you are pregnant with twins.
You can feel these symptoms due to these changes:
Palpitations, dizziness, fatigue, and dyspnea.
These are typical signs and symptoms of pregnancy. The tricky aspect is that they also correspond with some heart disease symptoms.
Therefore, you may be exhibiting warning signs of heart disease but be unaware of them. So, heart issues during pregnancy can be harmful.
Heart issues during pregnancy may be more likely in individuals with pre-existing heart disease. The nature and severity of the illness you have will determine your risk.
Heart issues during pregnancy
Preexisting heart diseases
- Congenital heart disease
In the United States, congenital heart disease which can range in severity from mild to severe is the most prevalent type of heart issues during pregnancy.
Even after receiving treatment or surgery at a young age, babies with significant diseases may still undergo changes in their heart's functionality.
Before getting pregnant, women with congenital heart disease should speak with their doctor about their risks and how to handle unexpected pregnancies. Common complications include abnormal heartbeats, heart failure, and higher risks of premature birth.
- Cardiomyopathy
It is a leading cause of pregnancy complications and can lead to heart failure in up to 4 in 10 pregnant individuals. Hypertrophic cardiomyopathy is less dangerous but may cause complications, especially if symptoms were present before pregnancy.
- Heart valve disease
It is one of the heart issues during pregnancy. It can impact pregnancy and manifest in a variety of ways, from minor to severe. Aortic valve regurgitation, mitral valve prolapse, regurgitation of the mitral valve, and stenosis of the mitral valve are risk factors.
Before getting pregnant, severe regurgitation can require mitral valve surgery. The most frequent heart-related issue, mitral valve stenosis, may require surgery before pregnancy.
Many people with valve illness can live longer, healthier lives by having their valves replaced. But because they are more likely to get blood clots during pregnancy, women with artificial heart valves require extra caution.
To reduce the risk of blood clots, anticoagulant medicine must be taken for life. Consultation with a cardiologist is recommended to address pregnancy concerns, anticoagulant therapy, and endocarditis prophylaxis.
- Aortic disease
It is sometimes referred to as aortopathy, and is a condition that affects the aorta and raises the possibility of heart issues during pregnancy because of elevated pressure.
The risk is increased by genetic syndromes such as Turner syndrome, Loeys-Dietz syndrome, Marfan syndrome, Bicuspid aortic valve, history of aortic dissection, and Vascular Ehlers-Danlos syndrome.
Aortic dissections and ruptures associated with pregnancy usually happen in the third trimester or the postpartum phase.
Heart diseases that develop during pregnancy
- Hypertension
It is one of the most common heart issues during pregnancy. Up to one in ten pregnant women experience high blood pressure. And it's happening more frequently. When compared to White people, Black people have a greater increase. It includes:
- High blood pressure that starts after week 20 of pregnancy and is at least 140/90 mmHG is known as gestational hypertension.
- High blood pressure that starts after week 20 is known as preeclampsia. It happens when there is evidence of organ damage or protein in your urine.
- Eclampsia is the term used to describe preeclampsia plus seizures that happen during pregnancy or within ten days of giving birth.
- High blood pressure that starts before week 20 or before you get pregnant is known as chronic hypertension.
- Chronic hypertension along with protein in urine or evidence of organ damage is known as chronic hypertension with superimposed preeclampsia.
- Gestational diabetes
After week 20 of pregnancy, elevated blood sugar is known as gestational diabetes. In the US, this disorder affects roughly 6 out of every 100 pregnancies.
People from all ethnic origins are susceptible to it. Gestational diabetes increases the risk of complications for both you and your unborn child if left untreated.
- Arrhythmia
Also, it is one of the heart issues during pregnancy. Whether or not you have previously experienced an arrhythmia, being pregnant increases your chance of developing one. It includes:
- Ectopic heartbeat: Usually harmless, this is an additional heartbeat.
- Supraventricular tachycardia: It is a common sustained arrhythmia during pregnancy, affecting individuals with a history of SVT or congenital heart disease, or may occur for the first time.
- Myocardial ischemia
It refers to inadequate blood flow to the heart. It may result in stable angina, unstable angina, and heart attack. It accounts for about 2 out of every 25,000 hospitalizations connected to pregnancy, so heart issues during pregnancy.
Among the risk factors for pregnancy are: being over 30 years old, obesity, hypertension, diabetes, family history of cardiovascular disease, and smoking.
Symptoms of heart issues during pregnancy
Certain heart-related symptoms are similar to what you would often experience during pregnancy:
It includes shortness of breath, fatigue, swelling at ankles and feet, and the need to urinate often.
It's possible that these symptoms are not harmful Nevertheless, they can indicate a cardiac issue if:
- They start following the 20th week of gestation.
- They impede your ability to perform your regular everyday activities.
- Even at rest, you experience dyspnea.
- You wake up during the night because you are having trouble breathing.
The following symptoms are abnormal during pregnancy
It includes angina, tachycardia, palpitation for more than 30 seconds, blurred vision, and syncope.
Management of heart issues during pregnancy
Preparation for pregnancy
Before trying to conceive, consult your health care team, including your heart doctor and maternal-fetal medicine specialist. They will assess your heart condition management and consider treatment changes.
Certain heart-conditioning medications may be adjusted during pregnancy, and it's crucial to understand the risks involved. If you have an unexpected pregnancy, see both a cardiologist and a high-risk pregnancy doctor immediately.
Labor and delivery
Your healthcare team may recommend the delivery at a medical center specializing in high-risk pregnancies. Induced labor is a procedure used to help a pregnant woman go into labor under controlled conditions.
Special equipment may be used to monitor your health during labor, including your heart rate and rhythm. Anesthesia may be administered through epidural or spinal block injections. If you give birth through a vagina, the team may limit pushing.
Antibiotic treatment may be given if you are at risk of endocarditis. C-sections are rare due to heart conditions, but special care is taken to track your heart health during delivery.
Breastfeeding
It is recommended for women with heart issues during pregnancy, even those taking medicine. Consult your healthcare team for treatment changes.
Pregnant women with endocarditis risk mastitis, so pumping and feeding from a bottle may be recommended instead of breastfeeding.
Conclusion
Your healthcare physician might suggest a procedure to improve the function of your heart, depending on your condition. It's usually preferable to have these operations done prior to getting pregnant.
Your healthcare team will assess your condition and choose the best course of action.
In order to control specific heart issues during pregnancy or risk factors related to it, you could also require medication. Discuss which medications are safe to use and which are not during pregnancy with your healthcare professional.
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