Pregnancy: managing cardiac risks

Pregnancy and heart rhythm disorders: understanding the risks

In most cases, it is possible to carry a child after a heart attack or while suffering from heart disease. Only certain conditions present an extremely high risk of serious complications: cardiomyopathy that occurred during another pregnancy, or, above all, heart failure.

However, in all cases, close monitoring is required to minimize possible complications. Pregnant women who have suffered from a heart condition or cardiac arrhythmia are 15 times more likely to experience complications for their baby than other women, and even 100 times more likely to die themselves if they are not properly cared for. This is because during pregnancy, the heart is under particular strain: it is estimated that it adapts as much as that of high-level athletes. The heart beats faster to ensure blood flow to the placenta and the baby. In addition, childbirth itself puts intense strain on the heart. Women with heart disease may see their condition worsen or even become apparent during pregnancy.

They are also at greater risk of preeclampsia—a condition involving high blood pressure and protein in the urine—and gestational hypertension. Finally, premature births are more common.

The importance of screening for heart rhythm disorders for the health of mother and baby

To minimize the effects of a heart rhythm disorder during pregnancy, it is best to first assess the risks involved. A cardiac assessment is therefore necessary before pregnancy, or as early as possible during pregnancy if it was unplanned, in cases of a family or personal history of heart disease, or if the person has previously undergone chemotherapy or radiotherapy. If you have high blood pressure, phlebitis, or pulmonary embolism, if you have gestational diabetes, a heart murmur, or if you have a first-degree relative who has died suddenly, it is imperative to have this screening done. The same applies to all pregnancies after the age of 40.

Monitoring and identifying cardiovascular symptoms during pregnancy 

One of the symptoms that should raise alarm bells during pregnancy is shortness of breath, particularly during physical activity. Some people may also experience dizziness or even fainting due to a lack of oxygen supply to the brain. Excessive fatigue, not necessarily related to exertion, is also common. Palpitations, i.e., rapid or irregular heartbeat, may be felt, as well as feelings of suffocation. Headaches, uterine bleeding, and edema are also possible symptoms.

Adapting your lifestyle for a more peaceful pregnancy

Getting pregnant when you have had or still have heart rhythm disorders requires taking a number of measures. First, of course, close medical monitoring by both an obstetrician and a cardiologist. Next, moderating physical activity: this does not mean stopping altogether, especially as some activities—such as walking and swimming—can be particularly beneficial. But it does mean adapting them, again with the approval of your doctors, so as not to overwork your heart. 

Stress must be given special attention: meditation, breathing, concentration, and mindfulness exercises are particularly recommended. Mindfulness meditation helps protect the heart by improving well-being, reducing stress, and lowering anxiety.

A change in eating habits will sometimes be necessary to achieve a better balance. Finally, it may also be recommended to change, on prescription of course, certain medications that were previously recommended but could prove harmful to the baby.

Childbirth and heart rhythm disorders: what precautions to take ?

When giving birth, special precautions must be taken if you have heart rhythm disorders. Starting with the location: it is best to choose a medical center where a team will be able to treat cardiac complications. The method of delivery may also be determined in advance, leading to a cesarean section: cesarean sections account for 41% of deliveries for women with heart disorders, compared to 23% in the general population. Finally, analgesia methods must take into account the mother’s medical history.

Some tips for better understanding the postpartum period

After giving birth, regular medical follow-up is essential, particularly with an obstetrician and cardiologist. They will help to ensure that recovery is proceeding normally and prescribe appropriate treatment. 

Most parents experience sleep deprivation during the first few months of their baby’s life; for mothers with heart rhythm disorders, this can cause dangerous stress. Family and friends, as well as support groups, can be a valuable source of support.

Finally, when mothers choose to breastfeed, it is sometimes necessary to adjust their medication.