Definition and Overview

Pregnant women are especially vulnerable to a variety of medical conditions and issues that can threaten their and their children’s lives. Pregnancy can stress out the woman’s heart and circulatory system, which can pose serious risks not only for the impending birth but also cause serious long-term complications for the mother.

During pregnancy, a woman’s blood volume typically increases from thirty to fifty percent, all in order to provide nourishment for the growing fetus. However, as blood volume increases, so does the amount of work the heart has to perform. A pregnant woman’s heart has to exert twice as much effort to circulate the increased volume of blood throughout her body and the fetus as well. Even healthy mothers can experience heart problems during pregnancy. Delivery and labor can also cause serious stress to the heart, as the body’s blood pressure and flow drastically change. After the birth of the baby, the heart muscles can also be stressed as blood flow and pressure decrease.

Women with pre-existing heart conditions might also experience complications and more severe signs and symptoms during pregnancy, labor, and delivery.

Some common heart problems experienced by pregnant women include the following:

  • Abnormalities in heart rhythm are very common among pregnant women. While having irregularities in the pumping of the heart, this is normal and usually not a cause for concern.

  • Congestive heart failure is comparatively rare, but can be quite serious if the mother has a predisposition to this condition. With congestive heart failure, the changes in blood volume and pressure can cause the heart to weaken. If it does, the blood will circulate slower throughout the body and will fail to provide enough nourishment and oxygen to the organ systems. The heart muscles can stretch, thicken, or stiffen, unable to pump blood efficiently. Congestive heart failure can cause more fluid and salt retention in the pregnant woman’s body, also causing fluid build-up in the lungs, feet, arms, ankles, and legs.

  • Congenital heart defects can be aggravated by the increased blood pressure and flow in a pregnant woman’s body. Women born with heart problems can give birth to babies with similar heart defects. Premature birth is also a risk.

  • Malformed or scarred heart valves that do not work efficiently can also contribute to the risk of endocarditis, an infection of the heart valves and the endocardium, which lines the heart.
    Peripartum cardiomyopathy is a rare heart problem for pregnant women, but it can also occur right after the baby has been delivered. The patient’s heart is unable to cope with the increased blood flow and pressure in the body, which then weakens the cardiac muscles. These muscles enlarge over time to accommodate the additional workload.

Some cardiovascular conditions can affect the female patient very seriously that pregnancy is not recommended at all. Even something as common as hypertension (high blood pressure) can affect the heart’s right ventricle and the arteries in the lungs.

Cause of Condition

A pregnant woman’s body undergoes a variety of changes to ensure the safety, comfort, and nutrition of the baby inside her. The cardiovascular system is one of the organ systems that undergo many changes, which in turn can affect the individual’s cardiovascular and general health. The changes in the woman’s circulatory and cardiovascular systems begin in her first trimester, typically peaking during the second, plateau in the third trimester, before normalizing or disappearing after the baby is born.

As blood volume increases to up to fifty percent to provide oxygen and nourishment for the fetus, the pregnant woman’s heart needs to increase its rate and pressure in equal amounts. A pregnant woman’s heart typically beats faster, with an additional ten to fifteen beats per minute. This additional demand for cardiac performance can take a serious toll over time.

The position of the fetus inside the womb can also affect the circulatory and cardiovascular systems of the mother. The fetus can hinder the efficiency of blood vessels in circulating blood. The mother’s blood pressure also varies greatly at different points of the pregnancy, rising and dipping sharply, which can cause additional cardiovascular problems.

Delivery can also trigger heart problems for the mother. Changes in the heart rate, cardiac output, blood volume, and blood pressure typically occur rapidly, causing stress to the heart and blood vessels.

Risk factors for heart diseases and conditions during pregnancy include the following:

  • Being obese
  • Having a personal or family history of heart disease, especially myocarditis or the inflammation of the cardiac muscles
  • Poor nutrition before and during the pregnancy
  • High alcohol intake
  • Multiple pregnancy
  • Being over thirty years old during the time of pregnancy

Key Symptoms

Heart diseases during pregnancy can cause the following signs and symptoms:

  • Palpitations
  • Faster heartbeat
  • Feeling tired all the time
  • Swelling of feet, hands, ankles, and arms, due to increased fluid and salt retention
  • Frequent urination at night
  • Shortness of breath, even without performing strenuous activities

Who to See and Types of Treatment Available

In normal, healthy patients who have recently given birth, cardiac output, blood volume, and blood pressure returns to normal two to six weeks after the baby has been delivered.

Any problem related to pregnancy is handled by an obstetric and gynaecologist (OB-GYN). In cases where the pregnant woman experiences or develops heart disease during pregnancy, the OB-GYN may elect to work hand in hand with a cardiologist, a medical professional specializing in the diagnosis and treatment of heart problems.

Medication can be prescribed with careful consideration that anything the patient takes will affect her baby too. The medications are expected to manage the symptoms and prevent them from worsening and risking the mother’s and baby’s health.

In most cases, the doctor will be hesitant to prescribe treatment for heart disease during the pregnancy. The patient might be required to stay in the hospital for close monitoring and emergency treatment.

References:

  • Cardiovascular Research Foundation
  • Mayo Clinic Foundation: “Heart Conditions and Pregnancy.”
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