A cardiologist's explanation of heart risks during pregnancy

Published: Feb. 26, 2015 at 9:20 PM CST|Updated: Feb. 27, 2015 at 2:55 AM CST
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BATON ROUGE, LA (WAFB) - Pregnant women get a lot of advice, but it's what they're not expecting that could be a problem. Recognizing signs of heart trouble is vital to the health of both mom and baby.

Ask any expectant mother…making a human takes a lot of energy. The heart pumps about 40% more blood throughout the body during pregnancy, and that extra work can take a toll. But when does normal fatigue become a warning sign of something more sinister?

"They can't lay down flat at night, they can't walk more than a few feet, they feel their palpitations, they feel like they can't breathe. Those are things you definitely see a doctor for, because those are not normal," said Dr. Tara Jarreau, a cardiologist with Louisiana Cardiology Associates.

As one of the few females in her specialty, Jarreau often deals with pregnant patients, but recently got some added perspective.

"I had a little queasiness in the first trimester, but that got better," she said with a smile. "The fatigue is getting better. I've been lucky so far."

Now at 22 weeks, she's watching for key symptoms like a rise in blood pressure.

"The normal physiological response to pregnancy is that the blood pressure goes down, however some women tend to develop gestational hypertension or even preeclampsia, and that's when the blood pressure goes up, and that's an adverse reaction. That's bad," she explained.

Heart conditions are a leading cause of maternal death associated with pregnancy, occurring in roughly one in 25 to 50 pregnant women. Other conditions that may be brought on by pregnancy include arrhythmias and congestive heart failure. Peripartum cardiomyopathy is a rare but dangerous development of heart failure that Jarreau calls "the worst of what we see."

"Peripartum cardiomyopathy usually presents in the last trimester of pregnancy or the first few months after delivery. No one can really pinpoint the cause, and the patients who don't get better may go on to needing a heart transplant," she said.

Jarreau encourages her patients to maintain a heart-healthy diet. "Eating for two" is a myth, she said. 300 to 500 extra calories per day is all that's needed.

A recent survey showed that many Americans don't know what a heart-healthy diet is, often assuming that a low-fat diet is best for their ticker.

"It turns out that evidence has gradually accumulated over a long period of time that ultra-low-fat diets or low-fat diets are not particularly heart-healthy and don't seem to help with obesity," said Cleveland Clinic cardiologist Dr. Steve Nissen.

The Mediterranean Diet is now the go-to, heavy on fruits, vegetables, whole grains and fish. It's not considered low-fat and contains a lot of good, healthy fats like olive oil.

"There are things in olive oil that do promote heart health, and in fact, may even reduce the risk of developing diabetes," Nissen said.

Most pregnant women will not require the care of a cardiologist, but knowing the signs of a distressed heart can save lives:

- Irregular or racing heartbeat

- Swelling, particularly in the lower extremities

- Excessive fatigue

- Chest pain

- Unusual shortness of breath

- Difficulty breathing while lying flat

Treatment during pregnancy is also a challenge, because medications are often limited due to their risk to the baby. Even after birth, medications remain a risk because they can be secreted in the breast milk.

For more information on living heart healthy, visit this website.

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