Many women in their child-bearing years don’t concern themselves with the risks of heart disease. But the truth is, heart disease is a real and relevant issue for women of all ages. In fact, according to the American Heart Association, nearly 45% of females 20 years and older are living with some form of cardiovascular disease and less than 50% of women entering pregnancy in the United States have good heart health. This February, in honor of Heart Month, we hope to inspire women of all ages to pay closer attention to their cardiovascular risk.
What is peripartum cardiomyopathy?
Peripartum cardiomyopathy is a heart condition that some women get during pregnancy or soon after childbirth. It happens when the heart muscle stretches more than normal and becomes weak, which can lead to issues like heart failure. This means your heart can't pump enough blood to the rest of the body, so blood can get backed up in your lungs and legs.
Symptoms may appear during late pregnancy or in the months after childbirth. As the heart muscle weakens, you may feel short of breath. Other symptoms include feeling very tired, having swelling in the legs, and having trouble breathing while lying down. You may also feel faint or dizzy, experience chest pain, a rapid heart rate or a cough.
How is peripartum cardiomyopathy diagnosed?
Your doctor will ask about your symptoms, personal health history and family history. Your provider will administer a physical exam and order tests, including an echocardiogram (echo) and an electrocardiogram (EKG or ECG). They may also get a chest X-ray and an ultrasound of your heart.
How is peripartum cardiomyopathy treated?
Treatment focuses on relieving symptoms and helping your heart work better. It may include taking medicine.
What are the risk factors for peripartum cardiomyopathy?
Your risk is higher if you:
- Have high blood pressure or preeclampsia.
- Had high blood pressure or preeclampsia during a past pregnancy.
- Are pregnant with twins or more.
- Are age 30 or older.
- Smoke, drink alcohol, or use drugs.
- Are very overweight.
- Had cardiomyopathy in a past pregnancy or have a family history of it.
- Take or have taken medicines to treat preterm labor.
Pregnancy-related heart problems are more common and more likely to cause death in people who are Black, American Indian or Alaska Native. The reason for this is unknown, though less access to good healthcare and differences in how patients are treated are contributing factors. Other health, economic and social issues, including racism, also increase the risk for these groups. If you have concerns about unfair treatment, share them with your doctor and talk about what you can both do to ensure clear communication.
How can you care for yourself when you have peripartum cardiomyopathy?
Take your medicines as prescribed and let your doctor know if you're having problems. Be sure to go to all doctor appointments. This will help your doctor find and treat problems early. Eat healthy, low-sodium foods. Talk to your doctor about what activities are safe for you and avoid tobacco and alcohol.
When should you seek medical assistance?
Call 911 anytime you think you may need emergency care, including:
- If you have symptoms of sudden heart failure: Severe trouble breathing, a fast or irregular heartbeat, coughing up pink, foamy mucus, passing out or chest pain
- If you have new or changed symptoms of heart failure, such as: new or increased shortness of breath, swelling in your legs, ankles, or feet, sudden weight gain (more than 2 to 3 pounds in a day or 5 pounds in a week, depending on doctor’s specifications), feeling dizzy or lightheaded or like you may faint, feeling so tired or weak that you cannot do your usual activities, not sleeping well, shortness of breath that wakes you at night
Watch closely for changes in your health and be sure to contact your doctor if you have any problems.
How can a woman prevent problems from peripartum cardiomyopathy?
You may not be able to prevent cardiomyopathy during your pregnancy. But you can take steps to lower your chances of having problems from this heart condition.
Watch for symptoms of cardiomyopathy late in your pregnancy. If you have swelling in your legs, feel very tired, have trouble breathing, or have other symptoms, tell your doctor right away.
Share your health history with your doctor. Tell your doctor if you have heart disease or a family history of it. Also tell them if you have high blood pressure and if you had high blood pressure or preeclampsia during a past pregnancy.
Trust yourself and be direct. You are the expert on your body. If something doesn't feel right, get help. If you don't feel like you're being heard, say so. You can say, “I know that pregnancy has risks. I want to be sure I'm getting good care.” You could also ask a friend or family member to help you talk to your doctor. For some people, seeing a different doctor may be an option.
Try to be active most days. Talk to your doctor before you start an exercise program.
Eat a variety of healthy foods. These include vegetables, fruits, lean protein and whole grains. Also eat foods low in sodium.
Stay at a healthy weight for you. Talk to your doctor about how much weight you should gain during pregnancy.
Avoid smoking or using tobacco. If you need help quitting, talk to your doctor.
Avoid using alcohol or illegal drugs, such as cocaine. If you think you may have a problem with alcohol or drug use, talk to your doctor.
Take your medicine as prescribed. Let your doctor know if you are having problems with medicine.
Be sure to go to all doctor appointments. When you are pregnant and during the months after delivery, regular checkups help the doctor find and treat problems early.
Women’s heart health is crucial at all stages of life. If you are pregnant or could become pregnant and you are at high risk for heart disease, consider asking your physician for a referral to the Women’s Heart Clinic at Parkview Heart Institute.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.