Heart disease in pregnancy

Heart disease in pregnancy

Cardiac Diseases in Pregnancy: A Patient Education Guide

Cardiac diseases during pregnancy require careful management to ensure the health of both the mother and the baby. With proper care, most women with heart conditions can have a safe pregnancy.

Types of Cardiac Diseases in Pregnancy:

  1. Congenital Heart Diseases: Heart conditions present since birth.
  2. Acquired Heart Diseases: Conditions developed later, such as rheumatic heart disease or cardiomyopathy.
  3. Peripartum Cardiomyopathy: A type of heart failure occurring in late pregnancy or shortly after delivery.

Why is it Important?

  • Pregnancy increases the workload on the heart due to higher blood volume and cardiac output.
  • Unmanaged heart conditions can lead to complications such as heart failure, arrhythmias, preterm delivery, or restricted fetal growth.

Symptoms to Watch For:

  • Shortness of breath, especially when lying down.
  • Swelling in legs, ankles, or hands.
  • Fatigue that is out of proportion to usual pregnancy fatigue.
  • Chest pain or palpitations.
  • Dizziness or fainting.

Do's and Don'ts for Managing Cardiac Diseases in Pregnancy

Do's:

  • Attend Regular Check-ups: Work closely with your obstetrician and cardiologist to monitor your condition.
  • Follow Medication Guidelines: Take prescribed medications as directed by your doctor.
  • Eat a Heart-Healthy Diet: Focus on fresh fruits, vegetables, whole grains, lean protein, and low-sodium options.
  • Engage in Safe Physical Activity: Light exercises like walking or prenatal yoga (if cleared by your doctor).
  • Track Symptoms: Keep a log of any changes in your symptoms and report them immediately.

Don'ts:

  • Avoid Overexertion: Rest when needed and avoid strenuous activities.
  • Do Not Skip Medications: Missing doses can lead to serious complications.
  • Limit Salt Intake: Excess sodium can increase blood pressure and fluid retention.
  • Avoid Smoking and Alcohol: Both can exacerbate heart conditions.
  • Don’t Delay Emergency Care: Seek immediate medical attention for concerning symptoms like severe chest pain or difficulty breathing.

Medications for Cardiac Diseases in Pregnancy

Safe Medications in Pregnancy:

  1. Beta-blockers:
    • Bisoprolol: 
    • Metoprolol: May be used under medical supervision.
  2. Diuretics:
    • Frusemide: Used cautiously for fluid management.
  3. Anticoagulants:
    • Low-Molecular-Weight Heparin (e.g., Enoxaparin): Preferred for preventing blood clots.
  4. Digoxin: Can be used for certain arrhythmias and heart failure.

Medications to Avoid During Pregnancy:

  • ACE inhibitors (e.g., Enalapril, Lisinopril)
  • ARBs (e.g., Losartan, Valsartan)
  • Direct oral anticoagulants (DOACs, e.g., Rivaroxaban)

Safe Medications for Breastfeeding Mothers:

  • Bisoprolol and Metoprolol: Pass minimally into breast milk and are safe.
  • Low-Molecular-Weight Heparin: Compatible with breastfeeding.
  • Digoxin: Generally safe with monitoring.

When to Seek Emergency Help:

  • Sudden onset or worsening of chest pain.
  • Severe shortness of breath.
  • Fainting or loss of consciousness.
  • Rapid or irregular heartbeat that does not improve.
  • Swelling or pain in one leg (possible blood clot).

Conclusion:

Managing cardiac diseases in pregnancy involves a multidisciplinary approach, including obstetricians, physicians, cardiologists, and sometimes anesthesiologists. Early diagnosis, regular monitoring, and adherence to treatment plans are crucial for a healthy pregnancy. Always communicate openly with your healthcare team and report any concerning symptoms immediately.