While the idea of becoming pregnant with a heart condition might seem a
little scary, Margaret Miller, MD, director of the Women’s Medicine
Collaborative, says most women with heart disease – including conditions
like arrhythmia, heart murmurs, mitral valve prolapse and high blood
pressure – will have a healthy baby, especially if they receive the
proper care and monitoring.
“There are still some who believe that women with heart disease or
cardiac issues shouldn't get pregnant because it would be too
risky. However, that’s definitely not the case. Heart disease and
cardiac conditions can be safely managed during pregnancy,” says Miller,
an obstetric medicine physician who cares for pregnant women with
underlying medical conditions.
She recommends women with existing heart conditions carefully plan their
pregnancies and be sure they are using an effective form of birth
control until their disease is adequately controlled. It is also
recommended that these women seek care from a multidisciplinary team of
providers who have expertise in the management of cardiac issues in
“Women with heart conditions should consider a preconception consult,
which will give the woman and her physician an opportunity to optimize
cardiac function, discuss risks in pregnancy, review medications and
make a plan for the pregnancy, as well as labor and delivery,” Miller
says. “Many heart medications can be used safely during pregnancy, and
in fact, untreated cardiac disease can pose a greater risk than most
According to Miller, pregnancy is associated with significant changes in
the cardiovascular system. The heart rate increases by an average of 10
to 20 beats per minute, and because the heart is pumping more blood, the
cardiac output is higher. These normal physiologic changes can cause
many pregnant women to experience heart palpitations, or a fast heart
rate, a common – yet harmless – cardiac “symptom.”
There is a heart condition specific to pregnancy called peripartum
cardiomyopathy, which is a form of heart failure that can occur in the
last month of pregnancy or early postpartum period. It is rare, but
Miller says women who experience a significant and new onset of
shortness of breath, palpitations, lightheadedness or chest pain in the
end of pregnancy or postpartum should be checked by their physician as
soon as possible.
While actual heart attacks during pregnancy are very rare, Miller says
the rise in obesity and diabetes could lead to more cases in the future.
“Most providers do not think about a heart attack in a young woman, but
women who have new onset chest pain – especially if it is associated
with shortness of breath, sweating, nausea or dizziness – should receive
medical treatment right away,” she adds.
She also points out that women who have preeclampsia – a potentially
serious condition in pregnancy characterized by high blood pressure,
sometimes with fluid retention and protein in the urine – during their
pregnancy have a higher risk of heart disease later in life.
“Knowing that preeclampsia can potentially ‘predict’ who might go on to
develop heart disease, we can now be vigilant when it comes to screening
and testing women with a history of preeclampsia in order to
prevent the onset of disease,” Miller says.