Pregnancy can take its toll on even the healthiest person.
With so many changes going on on the inside, there’s bound to be some detrimental side effects, especially to the heart – the life centre of the body.
Between the increased blood volume and hormones softening the muscles, your cardiovascular system has to work twice as hard pumping away day and night to transport nutrients and oxygen.
While many expectant mums can weather through these tough changes without any significant problems, others may experience heart-related complications during pregnancy.
This is where pregnancy may cause heart troubles, a condition known as cardiomyopathy.
But let’s not get ahead of ourselves.
Here’s what you should know first about heart issues in general and what causes them.
Common Types of Heart Issues
The cardiovascular system can be affected by various conditions.
These are mainly caused by congenital defects, hereditary factors, poor lifestyle or a combination of all three.
Risk factors that all heart diseases have in common are usually obesity, smoking/drinking, age, diabetes, stress and taking certain types of medication.
A diet high in cholesterol and a sedentary lifestyle are also to blame.
The end result is almost usually stroke, paralysis or death.
Doctors will always check your genetics and family history to see if you have a risk of heart disease during pregnancy.
The most common types of heart issues or heart disease include hypertension, coronary artery disease, heart failure, arrhythmia, and cardiomyopathy.
Hypertension or also known by its more common name ‘high blood pressure’ is marked by elevated blood pressure.
Coronary Artery Disease is caused by a narrowing or blockage of the coronary arteries that can lead to chest pain (angina) or heart attacks.
Heart failure is a condition where the heart cannot pump blood effectively, leading to fatigue, shortness of breath, and fluid retention.
Arrhythmias are irregular heartbeats that can cause palpitations, dizziness, or fainting. These are often genetic but can also be brought about by poor lifestyle choices.
And the last, which is our topic of interest, is Cardiomyopathy.
This is a disease of the heart muscle that can lead to heart failure. When pregnancy is involved, it’s a whole other story.
Can Pregnancy Cause Heart Troubles?
The short answer is ‘yes’.
But there are other things to keep in mind.
Pregnancy in general, regardless of genetics or lifestyle choices, places an enormous strain on the heart.
As mentioned, this is due to the increased blood volume, which forces the heart to work twice as much as to pump blood.
The cause of these changes are, of course, hormonal and serve to support the pregnancy.
The higher blood volume not only compensates for the growing nutrient and oxygen requirement for both mother and child. It also prepares the mother’s body in case of blood loss during delivery.
While most expectant mothers can adapt well to these new changes, some may develop heart complications, especially if pre-existing conditions are present.
The two most common heart troubles related to pregnancy are, of course, preeclampsia and gestational hypertension. These put an added layer of pressure on the mother’s cardiovascular system.
What are the Risk Factors of Gestational Hypertension and Preeclampsia
While often mistaken for one another, preeclampsia and gestational hypertension are different.
Gestational hypertension has no other additional side effects other than a high blood pressure. It usually precedes preeclampsia.
However, when preeclampsia comes into the picture, this is when doctors worry.
Additional symptoms include oedema (swelling of hands and face), protein in urine and severe headaches.
If not monitored and treated properly, it can cause organ damage, heart failure and eventually stroke or death.
The more times a woman has preeclampsia with each pregnancy, the higher her risk of death or pregnancy complications.
But there are other risk factors to take note of. These include:
- Being pregnant for the first time
- Multiple pregnancies (twins, triplets, etc.)
- Women over 35 years
- Obesity and high body mass index
- Family history of preeclampsia or hypertension
- Pre-existing chronic hypertension
- Other medical conditions like diabetes (Type 1 or Type 2), autoimmune disorders (e.g. lupus), chronic kidney disease, polycystic ovarian syndrome, etc.
- Short or long interpregnancy interval (e.g. less than 2 years or more than 10 years between pregnancies)
- Use of assisted reproductive technologies (IVF) – Alters placental development.
- Previous history of gestational hypertension or preeclampsia
While not many know the true cause of preeclampsia, doctors blame the condition on abnormal placental growth which causes poor blood flow from mother to child.
However, gestational hypertension and preeclampsia aren’t the only two heart troubles that can plague a pregnant mother.
What is Peripartum Cardiomyopathy?
A rare but life-threatening heart condition that has been known to plague expectant mothers is something called peripartum cardiomyopathy or PPCM.
This condition is a rare form of heart failure that occurs during the last month of pregnancy or within the first five months postpartum.
It is characterised by the heart’s inability to pump blood efficiently, leading to symptoms like shortness of breath (worse when lying down), swelling especially in the legs and feet (oedema), and fatigue.
Severe warning signs of PPCM include fainting, rapid weight gain, palpitations (arrhythmias) with frothy spittle, and chest pain.
The exact cause remains unclear, but it is believed to involve a combination of genetic, environmental, and hormonal factors.
It’s important to note that PPCM can affect women of any racial background, at any age during their reproductive years, and in any pregnancy.
However, certain risk factors have been identified, including advanced maternal age, multiple pregnancies (e.g., twins or triplets), a history of preeclampsia or hypertension, and African descent.
If you experience any of these factors, it is important to alert your doctor immediately.
Is Peripartum Cardiomyopathy Dangerous?
Yes, PPCM can be life-threatening in so many ways, including: heart failure, sudden cardiac arrest, thromboembolism, heart damage and, of course, death.
PPCM can cause severe heart failure, where the heart is unable to pump enough blood to meet the body’s demands.
In extreme cases, it leads to cardiogenic shock, requiring mechanical support (ventricular assist devices or heart transplantation).
Sudden cardiac death (SCD) can occur if the heart rhythm becomes dangerously abnormal (ventricular arrhythmias.
Due to poor heart function, blood can pool in the heart chambers, increasing the risk of blood clots. A condition known as thromboembolism.
Clots can travel to the lungs (pulmonary embolism), brain (stroke), or other organs, causing severe complications.
Some women recover fully within 6 to 12 months, but up to 50% experience persistent heart dysfunction.
If the heart does not recover, PPCM can lead to chronic heart failure or dilated cardiomyopathy, requiring lifelong medication or even a heart transplant.
The severity varies among individuals; some may experience mild symptoms, while others develop severe heart failure.
Delayed diagnosis can occur as symptoms often mimic those of normal pregnancy. Early detection and management are crucial to improve outcomes.
How Do Doctors Treat Heart Troubles During Pregnancy?
Prevention and management of gestational hypertension and preeclampsia often involves lifestyle changes (such as increasing physical activity) and close monitoring.
However, medication may sometimes be necessary.
Your doctor may prescribe antihypertensive medications such as labetalol, long-acting nifedipine, and methyldopa.
These medications help control blood pressure and reduce the risk of severe hypertension.
If you have a high risk of preeclampsia such as from, prophylactic (preventative) medication may be necessary.
Prescriptions include a low-dose aspirin from 12 to 36 weeks of gestation to significantly reduce the risk of preeclampsia.
Low-dose calcium supplementation during pregnancy may also reduce the risk of preeclampsia, particularly in women with low dietary calcium intake.
Treatment for PPCM, on the other hand, focuses on managing heart failure symptoms and supporting heart function. This may include medication and lifestyle changes.
If the symptoms are severe, more advanced therapies may be necessary.
Medications for PPCM include diuretics to reduce fluid overload, beta-blockers to manage heart rate, and ACE inhibitors to lower blood pressure.
Mums with PPCM can also resort to lifestyle changes such as dietary modifications, fluid restriction, and monitored physical activity.
In severe cases, devices like implantable cardioverter-defibrillators (ICDs) or even heart transplantation may be considered (but this is seldom).
Recent studies have explored the use of bromocriptine, a medication that inhibits prolactin secretion, showing promise in improving outcomes for PPCM patients.
Can You Prevent Heart Troubles During Pregnancy?
A study highlighted that approximately half of all serious cardiac events in pregnant women with heart disease are preventable. This emphasises the importance of proactive care.
While not all heart complications can be prevented, certain measures can reduce the risk.
If you have a medical history or family history of heart troubles, take note of these tips.
First is preconception counseling. Prevention begins even before you get pregnant.
Prospective mothers who know they have a medical or family history of heart conditions should consult healthcare providers before conception. This helps to assess risks and reduce them as much as possible.
Next is for when you actually are pregnant. Never downplay the importance of regular prenatal care.
Consistent monitoring by your OBGYN can help detect and manage potential issues early before they start to become a problem.
Your doctor will also remind you to lead a healthy lifestyle.
Pregnant women should maintain a balanced diet regardless of preexisting heart troubles.
This paired with physical activity ensures your heart keeps beating healthily throughout your entire pregnancy.
On a more specialised treatment, blood pressure management is paramount. Your doctor will monitor and control your blood pressure strictly to prevent conditions like preeclampsia from appearing.
Give Your Heart a Break
Whether its preeclampsia, gestational hypertension or peripartum cardiomyopathy, there are so many ways that your heart can suffer.
That small little organ in your chest works tirelessly day and night to keep you alive, even when you’re not pregnant, and now it’s pumping for two. It’s time we paid it more mind.
Paying attention to your body for signs, and not missing any of your prenatal exams and checkups are crucial for ensuring you or your baby do not experience any complications.
With early detection and appropriate management of any heart troubles, you’ll be able to coast through your three semesters with peace of mind.
Protect your hearts, mums, and have a great pregnancy ahead!
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
For more insightful stories and fun recipes, stay tuned to Motherhood Story!