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Pre-existing heart disease is a heart problem that you had before you got pregnant. This usually means a heart condition that you were born with (congenital). These can include heart problems that may have been fixed. It can also include heart valve issues.
Common heart issues that may be affected by pregnancy include:
Most heart problems you’re born with happen by chance. No one knows what causes them. A heart valve problem may come on after an infection or other health condition.
Even if your heart disease doesn’t cause symptoms or hasn’t affected your life, it can cause issues during pregnancy. This is because of changes in your body that happen when you’re pregnant.
Starting in your first trimester, your blood volume rises by about half. The extra fluid makes your heart work harder. Your heart responds by increasing its cardiac output. This is the amount of blood that goes through your circulatory system in 1 minute. Other systems in your body also respond. Your blood pressure decreases to allow the extra blood volume to flow.
Changes in your heart and vascular system can also happen during labor and delivery. Large amounts of blood move from your uterus into your circulation, as your uterus contracts. This causes changes in your blood pressure, heart rate, and cardiac output. If you get an epidural or spinal anesthesia, this can also cause your blood pressure to decrease.
After childbirth, your cardiac output increases and your heart rate slows down. You can have heavy blood loss with delivery. This can change your heart rate, blood pressure, and cardiac output.
Most women with a pre-existing heart issue have been diagnosed and treated before pregnancy. Some women with minor heart problems may not know that they have a heart issue. These women, and women with repaired heart conditions, may develop symptoms during pregnancy.
The following are common symptoms of heart disease. Symptoms can occur a bit differently in each pregnancy. They may include:
The symptoms of heart disease may look like symptoms of other health problems. Always see your healthcare provider for a diagnosis.
Heart problems are a possible complication in pregnancy. They happen in about 1 in 100 pregnancies.
Diagnosing a heart issue in pregnancy can be tricky. This is because some of the normal symptoms of pregnancy look like symptoms of heart disease.
Your healthcare provider will ask about your health history. He or she will also give you an exam. You may also need the following tests:
Treatment will depend on your symptoms, pregnancy, and general health. It will also depend on how severe the condition is.
Your healthcare provider will look at the risk that your heart disease may have on your pregnancy. You may need to see a high-risk obstetrician. You may also need to see a heart doctor (cardiologist) who specializes in congenital heart disease.
You may need to see your healthcare provider more often. This is so he or she can watch you and your baby. You may also need medicine to help your heart work better.
Your healthcare team will decide the safest way for you to have your baby. You may give birth vaginally or you may need to have a cesarean section. During labor, you may need to have your heart monitored continuously.
Normal changes in pregnancy may cause problems if you have heart disease. Your healthcare provider will watch you closely to make sure you and your baby stay healthy.
If you have a congenital heart defect, there’s a chance your baby will also have a heart issue. It may not be the same heart problem you have. You’ll likely need high-risk prenatal monitoring.
Congenital heart disease is a life-long condition. Most of the time, your heart defect is fixed in childhood. Other times, you may not have symptoms for many years.
But pregnancy causes changes that can cause problems for women with heart disease. Before you get pregnant, you should consider preconception counseling. A specialist with experience in pregnancy and heart disease can help you. This can help you make choices about pregnancy. It can also help you learn how to maintain or improve your health.
Call your healthcare provider if your heart symptoms get worse. You should also call him or her if you have any new symptoms.
Tips to help you get the most from a visit to your healthcare provider:
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.