Heart Health in Pregnancy

Shannon M. Clark, MD
January 28, 2022
Heart Health in Pregnancy

Pregnancy care sometimes involves a cardiologist

We often think of pregnancy as being something solely taken care of and overseen by an obstetrician and possibly a primary care physician, but in this conversation with cardiologist, Dr. Rachel M. Bond, we discuss how having a cardiologist is also an integral part of the care team for some pregnant individuals.

In my conversation with Dr. Bond, we cover topics such as preconception cardiovascular health and evaluation, acquired versus congenital heart disease, cardiovascular health in pregnancy, cardiovascular physiological changes in pregnancy, why some people find out they have heart disease for first time during pregnancy, postpartum cardiovascular health and disease, peripartum cardiomyopathy and more!

Heart health with Dr. Rachel Bond

Heart health in pregnancy

Cardiovascular disease and cardiomyopathy are leading causes of maternal mortality, and, as such, are important topics to talk about. The incidence of pregnancy in pregnant persons with congenital heart disease and acquired heart disease is on the rise.

You might be surprised to realize the major implications that pregnancy and delivery can have on your heart health. For those with pre-existing heart conditions, a cardiologist needs to be involved when making decisions about when and how a baby will be delivered. This is also true for both those with acquired heart disease.

Whenever possible, optimization of maternal cardiovascular health should be achieved before pregnancy. This starts with having an annual routine wellness visit including blood work to check things like cholesterol, as well as sharing with your physician family medical history, especially if family members have had heart attacks.

Who needs a cardiologist?

Persons with known cardiovascular disease should be evaluated by a cardiologist ideally before pregnancy or as early as possible during the pregnancy for the following reasons:

  • To accurately diagnosis and assess the effect pregnancy will have on the underlying cardiovascular disease
  • To assess the potential risks to the pregnant person and fetus
  • To optimize the underlying cardiac condition

Thanks to improved technology and advancements in medicine, we are now seeing more persons with congenital heart conditions make it to reproductive age and having children. For these individuals, there should be a conversation between the cardiologist and obstetrician to decide what is best for the patient.

Symptoms to watch for during your pregnancy

One of the most important parts of my discussion with Dr. Bond is at minute 15:00 where we discuss some of the symptoms that could indicate cardiovascular conditions. These include:

  • Difficulty sleeping
  • Needing to sleep with more pillows because you feel very out of breath when lying horizontal
  • Swelling in the legs that doesn’t go away when you elevate your legs
  • Pain or pressure in your chest

The symptoms of cardiovascular conditions can overlap with some symptoms that are considered normal during pregnancy, but if you are having these symptoms or they are worsening, speak with your obstetrician. You may need to be seen by a cardiologist.

The CDC Hear Her Campaign

The CDC Hear Her Campaign is a great resource as well. You and your support person(s) should know what the urgent maternal warning signs are- it can help save lives. I advise everyone who is pregnant or within the first year after delivery to keep this below list on hand.

Call a doctor immediately if you experience these symptoms during pregnancy or within the first year after delivery⤵️

CDC Hear Her Campaign

Learn more from Dr. Bond!

Dr. Bond recently spoke at the Women’s Heart and Vascular Symposium. You can learn more about her work here and on Instagram @whvsymposium. You can also connect with her on Instagram @drrachelmbond.

Advocate for yourself!

I’d like to leave you with this...

You know your body better than anyone so if you are having pregnancy symptoms that feel “off” or something worries you, talk to your physician. You are your own best advocate. If you have a physician that brushes everything off as being because you’re pregnant or you do not feel they are really listening to you, then look for another physician. There are physicians out there who will listen to you.

Shannon M. Clark, MD

Shannon M. Clark, MD

Shannon M. Clark, MD, MMS is a double board certified ObGyn and Maternal-Fetal Medicine Specialist, and founder of Babies After 35. In her roles as a clinician, educator and researcher at UTMB-Galveston, she focuses on the care of people with maternal and/or fetal complications of pregnancy. Dr. Clark has taken a special interest in pregnancy after the age of 35, which according to age alone, is considered a high-risk pregnancy.

Follow Shannon on TikTok @tiktokbabydoc, Facebook @babiesafter35, and Instagram @babiesafter35.

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