Pregnancy and Heart Disease

AHA Recommendation

A woman who has a history of heart disease, heart murmur, rheumatic fever or high blood pressure should talk with her healthcare provider before she decides to become pregnant. A woman who has congenital heart disease has a higher risk of having a baby with some type of heart defect. If this is your case, it's very important to visit your healthcare provider often. You may need to have diagnostic tests done, such as a fetal ultrasound test.
If you have a heart condition, you and your healthcare provider need to talk about it and plan for your pregnancy. You'll also need to think about what may be involved in caring for your child later.

Here are some important things for any pregnant woman to do:

• Eat a nutritious diet.
• Don't smoke or drink alcohol.
• Have your doctor approve any medicine you use (including over-the-counter drugs).

Some medicines that are safe to take when you're not pregnant should not be used when you're pregnant. They may harm your baby. If you have heart disease, you may need to take heart medications during your pregnancy. Your doctor can prescribe heart drugs that won't harm your baby.
What cardiac ailments can be acquired during pregnancy?
 
Some women with normal hearts experience cardiac "abnormalities" during pregnancy. Some of these are discussed here.

Heart murmurs

While you're pregnant, your doctor will often hear a heart murmur. This new sound is due to the extra blood flowing through your heart. Usually this doesn't mean anything is wrong with your heart. Rarely, however, a new murmur can mean that there's a problem with a heart valve. If you have a heart murmur, your doctor can find its cause.

Arrhythmias

Many people have fast or slow heartbeats that may be regular or irregular. These are called "arrhythmias." They can develop for the first time during pregnancy in a woman with a normal heart or as a result of previously unknown heart disease.
Occasionally these arrhythmias are noticed when taking the pulse. Most often, there are no symptoms and no treatment is required. Sometimes arrhythmias do cause symptoms such as palpitations, dizziness or lightheadedness. On rare occasions they can even cause fainting.
There can be other explanations for these symptoms, but if you have them, your doctor may want to check you for arrhythmias. Your doctor may also want to perform an ECG or have you wear a heart monitor for 24 hours to better understand your rhythm.
Again, most often you won't need treatment. If you do need treatment, your doctor will advise you about how it will affect you and your baby.

High blood pressure

High blood pressure (hypertension) is a serious complication of pregnancy. In a small number of cases, it’s present before pregnancy. However, about 8 percent of all pregnant women develop hypertension, most often after the 20th week. That's why you should have your blood pressure checked often all through your pregnancy. You should not take ACE inhibitors or ARB’s if you are pregnant or planning to become so.
Very high blood pressure can occur, with a rapid weight gain, swollen ankles and protein in the urine. This disorder is knows as "toxemia of pregnancy" or "pre-eclampsia." It affects the blood vessels, kidneys, liver and brain. Decreased blood flow through the placenta also occurs in pre-eclampsia and can lead to slower growth in the uterus and loss of the fetus. Pre-eclampsia often necessitates a pre-term delivery. In fact, pre-eclampsia is the leading cause of premature birth in the United States.
Pre-eclampsia is a serious complication of pregnancy. It requires immediate medical attention. It can progress to a life-threatening condition called eclampsia.  Visual disturbances, severe headaches and abdominal pain usually precede eclampsia.