What to Know About Heart Disease and Pregnancy

Heart disease can be a condition that a person has from birth (congenital) or one that develops later in life (acquired).

Heart disease during pregnancy refers to several types of problems that affect your heart, such as conditions like cardiac arrhythmias, high blood pressureheart failurecoronary artery disease, valve disorders, and congenital heart defects.

Heart disease complicates between 1% to 4% of pregnancies and is the leading cause of pregnancy-related death.

There are also some changes to the heart and circulatory system that are normal when a person is pregnant. That said, heart disease patients need to have close monitoring by their healthcare team during pregnancy to avoid complications.

Here’s what you need to know about heart disease and fertility, pregnancy, childbirth, and the postpartum period.

A pregnant woman with her hand on her chest talking to her female physician

DjelicS / Getty Images

Heart Disease and Fertility

Research has shown a possible link between infertility and developing heart disease. If you have concerns about your fertility and heart disease, share them with your doctor before you try to conceive.

Treatments are available that may improve fertility, including lifestyle changes, medications, hormonal treatments, and assisted reproductive procedures.

If you don’t regularly see a cardiologist (a doctor who specializes in heart disease), your primary doctor may refer you to one if they cannot answer your specific heart disease-related fertility questions.

PCOS

Some studies have found that people with infertility that is caused by polycystic ovary syndrome (or PCOS) might be at an increased risk for heart disease.

People with PCOS tend to have higher rates of high blood pressure and high cholesterol, which are both risk factors for heart disease.

Heart Disease and Gestation

People with some forms of heart disease—such as heart valve disorders or congenital heart defects—can often have successful pregnancies. Moderate or severe heart conditions may increase the risk of complications during pregnancy, labor, delivery, and postpartum.

During pregnancy, the body undergoes many changes to the circulatory system that put stress on the heart. Some of these changes include:

  • Blood volume increase by 40% to 50%
  • Increase in the amount of blood the heart pumps per minute
  • Heart rate increase by 10 to 15 beats
  • Blood pressure decrease

Pregnant people with heart disease may experience a worsening of their condition, or experience pregnancy symptoms like fatigue, shortness of breath, and lightheadedness more severely.

It’s essential to discuss risks and possible pregnancy scenarios with your healthcare team, which should include a cardiologist and potentially a neonatologist (a pediatrician who specializes in the care of newborns).

Your team will evaluate different aspects of your care throughout your pregnancy, including:

  • How well you are managing your heart condition
  • If medications need to be stopped, started, or adjusted
  • The need for any additional surgical interventions, treatment, or additional monitoring for you or your baby
  • The risk of your baby inheriting a heart defect
  • A careful plan for delivery specific to your condition

If you have a serious or severe heart condition, such as severe pulmonary hypertension or moderate to severe heart failure, talk to your doctor if you are considering getting pregnant.

While it’s rare, your doctor may advise against pregnancy to avoid life-threatening complications.

Risks

Pregnancy requires the heart to pump harder, which means that it has the potential to worsen a heart condition or even cause an underlying heart condition to produce noticeable symptoms for the first time. Complications such as fluid in the lungs (pulmonary edema), abnormal heart rhythm, or even stroke can also occur.

Risks during pregnancy will depend on the type and severity of the heart disease.

  • Minor heart conditions such as heart arrhythmia can be treated with medication if necessary.
  • Serious heart conditions such as an artificial heart valve carry an increased risk of developing a potentially life-threatening infection of the heart’s lining (endocarditis).
  • Congenital heart defects may increase the risk of premature birth and the baby developing a similar heart defect.
  • Congestive heart failure can worsen as blood volume increases during pregnancy.

Treatment

Depending on the specific heart condition and its severity, treatment options for pregnant people might include:

  • Routine heart function testing with an electrocardiogram or echocardiogram
  • Medication treatment (such as blood thinners) for heart conditions like valvular heart disease
  • Regular exercise
  • Healthy diet
  • Smoking cessation

Some medications may pose risks to the unborn baby during pregnancy. Doctors aim to prescribe the safest drug at the safest dose, depending on the condition.

If you want to adjust your dose or stop taking your medication, talk to your doctor. Do not try to change your dose on your own or abruptly stop taking a medication that you have been prescribed.

Concerning Symptoms

Symptoms of pregnancy can look like the symptoms of certain types of heart disease. Your doctor can explain normal vs. abnormal symptoms and make sure that you know what to keep an eye out for.

If you notice a change in heart disease-related symptoms that you had before you were pregnant, or if you notice any new symptoms, you will want to let your doctor know.

Symptoms that warrant a call to your doctor include:

  • Worsening chest pains
  • Difficulty breathing with exertion or at rest
  • An increase in abnormal heartbeats
  • Racing heartbeat or heart palpitations
  • Waking up at night with coughing or trouble breathing
  • Fainting

Heart Disease and Postpartum

Pregnancy puts added stress on the heart. When a person with heart disease makes it through a pregnancy and delivery without any apparent complications, it suggests that their heart was able to withstand the stress of pregnancy.

However, heart complications, or a worsening of a heart condition, can show up at any time within a year postpartum—even if a person had an apparently normal pregnancy.

Your care team will want to monitor you closely during the months after you give birth to watch for any lingering effects of pregnancy on your heart and body.

Recovery

After giving birth, the body needs time to recover from the intense physical experience, which can be particularly true for people with heart disease.

The amount of blood that your heart pumps per minute will likely get back to normal within a few weeks postpartum, but experts estimate that it may take anywhere from four to six months (or longer) for the heart-related changes of pregnancy to resolve. The timing depends on the type of heart disease that a person has.

In rare cases, some people develop postpartum cardiomyopathy (or peripartum cardiomyopathy), a form of pregnancy-associated heart failure. It usually happens in the last month of pregnancy but can occur up to five months postpartum.

The cause of postpartum cardiomyopathy is unknown, but it can be temporary, permanent, or even life threatening. People who develop postpartum cardiomyopathy usually do not have a previous history of underlying heart disease or any obvious risk factors.

When to Call a Doctor

Some symptoms might be signs of postpartum cardiomyopathy or another form of heart disease that could potentially lead to a heart attack or stroke.

Call 911 or seek emergency medical attention immediately if you develop the following symptoms:

  • Shortness of breath
  • Trouble breathing while laying down
  • Chest pain
  • Heart palpitations
  • Fluid retention
  • Fainting
  • Nausea or vomiting

Breastfeeding

Breastfeeding is recommended for most people with heart disease. Some recent studies have indicated that breastfeeding is beneficial for the heart. It’s also been linked to a lower risk of developing diabetes, high cholesterol, high blood pressure, and heart disease later in life.

If you want to breastfeed, you’ll want to discuss a few things with your healthcare team first. Talk to your doctor before you start breastfeeding if you:

  • Take medication for a heart condition
  • Have a congenital heart condition that increases your risk of endocarditis (a serious infection or inflammation of the heart)

Frequently Asked Questions

How do you reverse heart disease?

In some cases, damage that is caused by certain heart conditions—such as congestive heart failure and coronary artery disease—can be reversed with lifestyle and nutrition changes.

Your doctor might recommend exercising, eating a heart-healthy diet, stopping smoking, managing stress, and taking medication.

What are the early signs of heart disease?

Different kinds of heart disease produce different symptoms. The most commonly reported are:

  • Chest pain or discomfort
  • Palpitations
  • Lightheadedness or dizziness
  • Fainting
  • Fatigue
  • Shortness of breath

Sometimes, heart disease does not cause any noticeable symptoms at all, especially if it’s in the early stages.

The signs of heart disease can also look different in women than in men. For example, women may have pain in the neck, jaw, throat, upper abdomen, or back, and they may experience fatigue and nausea or vomiting.

Why is physical activity so important for preventing heart disease?

Physical activity is essential for preventing heart disease because it helps keep your heart and blood vessels healthy.

Exercise helps by raising your HDL (or “good”) cholesterol levels, aiding in weight management, lowering your blood pressure, and controlling your blood sugar—all of which can help reduce your risk for heart disease.

How does diabetes affect heart disease?

People with diabetes are more likely to develop heart disease, stroke, and heart failure than people who do not have diabetes.

Having diabetes raises the risk for heart disease because it is linked to high blood pressure, too much LDL (or “bad”) cholesterol, and high triglycerides.

Over time, high blood sugar can also damage the blood vessels and nerves related to your heart.

A Word From Verywell

Heart disease during pregnancy is a unique experience for each individual, but if you have it, know that you’re not alone. You will be closely monitored by your cardiologist, doctor, and OB-GYN before, during, and after pregnancy.

Social support is also a key component to coping with heart disease during pregnancy. In addition to your family and friends, you can find support from the American Heart Association’s Go Red for Women support network, WomenHeart, or your local healthcare system, which may offer online or in-person community support groups.

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  1. Ramlakhan KP, Johnson MR, Roos-Hesselink JW. Pregnancy and cardiovascular disease. Nature Reviews Cardiology. 2020;17:718-731.

  2. Verit FF, Zeyrek FY, Zebitay AG, et al. Cardiovascular risk may be increased in women with unexplained infertility. Clin Exp Reprod Med. 2017;44(1):28-32. doi:10.5653/cerm.2017.44.1.28

  3. Centers for Disease Control and Prevention. PCOS (polycystic ovary syndrome) and diabetes. Updated March 24, 2020.

  4. Canobbio MM, Warnes CA, Aboulhosn J, et al. Management of pregnancy in patients with complex congenital heart disease: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2017;135:e50-e87. doi:10.1161/CIR.0000000000000458

  5. Cleveland Clinic. Heart disease & pregnancy. Updated July 18, 2019.

  6. Texas Children’s Hospital. Heart disease and pregnancy.

  7. Hemnes AR, Kiely DG, Cockrill BA, et al. Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research InstitutePulm Circ. 2015;5:435-465.

  8. Jeejeebhoy FM. Prosthetic heart valves and management during pregnancy. Can Fam Physician. 2009;55(2):155-157.

  9. Anthony J, Sliwa K. Decompensated heart failure in pregnancy. Cardiac Failure Review. 2016;2(1):20–26. doi:10.15420/cfr.2015:24:2

  10. Northwestern Medicine. Cardiac signs and symptoms during pregnancy.

  11. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89-94. doi:10.5830/CVJA-2016-021

  12. Koenig T, Hilfiker-Kleiner D, Bauersachs J. Peripartum cardiomyopathy. Herz. 2018;43(5):431-437. doi:10.1007/s00059-018-4709-z

  13. March of Dimes. Warning signs of health problems after birth. Updated July 2018.

  14. Peters SA, Yang L, Guo Y, et al. Breastfeeding and the risk of maternal cardiovascular disease: a prospective study of 300,000 Chinese women. J Ame Heart Assoc. 2017;6;6. doi:10.1161/JAHA.117.006081

  15. Centers for Disease Control and Prevention. About heart disease. Updated January 13, 2021.

  16. Centers for Disease Control and Prevention. Women and heart disease. Updated January 31, 2021.

  17. University of Michigan Health. Physical activity helps prevent a heart attack and stroke. Updated August 31, 2020.

  18. Centers for Disease Control and Prevention. Diabetes and your heart. Updated May 7, 2021. 

  19. Dawson AJ, Krastev Y, Parsonage WA, et al. Experiences of women with cardiac disease in pregnancy: a systematic review and meta synthesis. BMJ Open. 2018;8(9). doi:10.1136/bmjopen-2018-022755