Pregnancy and Your Heart: 6 Things to Know

An obstetrician explains how to keep your heart healthy during pregnancy.

Many expectant parents are aware of the dramatic physical changes that happen during pregnancy, but did you know that the heart also undergoes changes during this time? That’s why heart health should be a priority for people who are pregnant or who want to be, says Dr. Inna V. Landres, an obstetrician and gynecologist and director of the Obstetric Cardiology Program at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine.

“Heart health is always important, but it’s especially key when you’re pregnant,” says Dr. Landres. “To optimize your pregnancy, be aware of potential symptoms to watch for and make sure you maintain a heart-healthy lifestyle.”

Here are six things to know about your heart during pregnancy.

1. Your heart works harder in pregnancy.

Several changes occur to your cardiovascular system during pregnancy. Your heart has to pump more blood through your body. Your cardiac output, the amount of blood your heart pumps in a minute, increases as much as 50%. As the pregnancy progresses, there tends to be an increase in heart rate and your blood pressure can change. These changes vary in individual patients and pregnancies, and most women don’t feel them.

Dr. Inna Landres

Dr. Inna V. Landres

2. A healthy lifestyle helps your heart function best in pregnancy.

To make sure your heart is working at its best, follow good health measures like getting regular exercise, managing stress, and eating a balanced diet.

“For most patients, exercise is safe and beneficial for mom and baby,” says Dr. Landres. But make sure your obstetrician is on board with the idea first. “There are a few heart and medical conditions that could make strenuous workouts in pregnancy unwise,” she says.

“A heart-healthy diet is always important,” adds Dr. Landres. Nutritious foods that help you and your baby stay healthy include beans and nuts, whole grains, low-fat dairy, lean protein like fish and poultry, and lots of fruits and vegetables.

3. Pregnancy symptoms can mimic heart issues.

Many people experience shortness of breath, leg swelling, occasional dizziness, and heart palpitations during pregnancy. It’s normal, if unwelcome.

In some cases, these signs could mean something more serious. It’s important to talk to your obstetrician or cardiologist about any unusual symptoms.

“Our job is to figure out if they are normal or signs of a heart problem, and, if necessary, do a further workup,” says Dr. Landres.

4. If you already have a heart condition, a specialist should weigh in.

For patients with heart disease, it’s ideal to schedule a visit before you get pregnant. “A preconception consultation with a maternal-fetal medicine specialist (an OB-GYN who treats high-risk pregnant patients) and your cardiologist is really important,” says Dr. Landres. “If you have congenital heart disease — which is a heart condition you’re born with — acquired heart disease, or hypertension, we want to see you to discuss potential risks of a future pregnancy and what we can do to improve your health before you pursue pregnancy.”

If you have high blood pressure that’s not well controlled, for instance, a specialist can help you rein it in before conception.

“If you are on medications for heart disease, we want to review them for safety in pregnancy and have a plan for an alternative drug if needed,” Dr. Landres adds.

During pregnancy, an obstetrician and cardiologist will coordinate to keep you and your baby healthy through pregnancy and postpartum. “With proper care, many people with preexisting heart conditions can have healthy pregnancies,” says Dr. Landres.

5. Some people develop heart-related conditions during pregnancy.

Some conditions can arise during pregnancy that affect your heart. These include arrhythmias, which are heart palpitations or irregular heartbeats. “They may be benign and managed with lifestyle changes like cutting out caffeine,” says Dr. Landres. Tell your doctor if you experience them, though, as some arrhythmias can represent a more serious issue.

Another condition, preeclampsia, can develop in the second or third trimester. It causes very high blood pressure and can affect multiple organs, including the heart. If this condition occurs, you will be closely monitored. Women with pre-existing high blood pressure and heart disease are at a higher risk for it. Be sure not to skip regular doctor’s visits and to follow all instructions if you’re told to regularly check your own blood pressure.

6. Care for your heart doesn’t stop after the pregnancy ends.

If you experienced preeclampsia, gestational diabetes, or high blood pressure in pregnancy, be sure to tell your doctor because these conditions can increase the risk for heart disease later in life, says Dr. Landres.

“Patients with these conditions should share this information with their primary doctor and get regular screenings for cardiovascular risks and diabetes,” she adds.

The good news is that new research suggests that maintaining a heart-healthy lifestyle after pregnancy can reduce the risk of developing heart disease for patients with these complications. Your doctor can give you advice on lifestyle changes and heart-healthy habits for life.

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