It is no surprise that a woman’s heart works harder when she is pregnant. After all, her blood needs to supply oxygen and nutrients to her growing baby. Furthermore, labor and delivery requires yet more work for the heart.

Because of this, pregnancy acts as a “stress test” that can unmask underlying heart disease. It is important to know, however, that the vast majority of women will have no heart problems during pregnancy.

Is your heart strong enough for pregnancy?

Women who already know they have heart disease should speak with their physician about their risk before getting pregnant. Talk with your doctor if you have:

  • heart murmur
  • heart valve problem
  • coronary artery disease
  • cardiomyopathy
  • heart failure

Despite having these conditions, many women will be able to have successful pregnancies. But some will need special monitoring and care by their physicians.

Some conditions are particularly dangerous in pregnancy, including:

  • pulmonary hypertension
  • aortic aneurysm
  • severe aortic stenosis
  • history of peripartum cardiomyopathy

Because these conditions can be life-threatening in pregnancy, women with these conditions should not get pregnant without having a careful discussion with a physician who is familiar with these disorders.

Cardiovascular risks and pregnancy

Even if you have not been diagnosed with a heart condition, some women may have one or more risk factors for coronary artery disease. If you have any of the following risks, talk with your physician before getting pregnant:

  • cigarette smoking
  • diabetes
  • hypertension (high blood pressure)
  • obesity
  • hyperlipidemia (high cholesterol)

Symptoms to watch for while pregnant

While you may not have been diagnosed with heart disease, women may have symptoms of underlying heart disease. If you are planning a pregnancy, it is important to let your doctor know if you have any of these symptoms:

  • shortness of breath
  • palpitations
  • fainting
  • chest tightness or chest pain

Have a heart-healthy pregnancy

Babies need their mothers to have healthy hearts. Take these steps for you and your baby:

  • If you smoke cigarettes, stop.
  • Eat a healthy diet with fruits and vegetables and avoid sugar-sweetened food and drinks. Consider the Mediterranean diet, which is proven to decrease heart disease risk.
  • Be physically active and limit the time you spend sitting, such as in front of the TV or computer screen. The American Heart Association recommends at least 150 minutes per week of moderate physical activity. Talk to your doctor before beginning any new exercise program.
  • Be sure your blood pressure and cholesterol are controlled.
  • Maintain a healthy weight.
  • It is also important to manage your stress and get enough sleep.

If you need help with any of these lifestyle changes, talk to your doctor.

Learning from past pregnancies

Interestingly, we know that women who have had preeclampsia or gestational diabetes in a previous pregnancy are at increased risk for cardiovascular disease in the future. It is especially important for these women to take measures to keep their hearts healthy. That way, they will be able to enjoy their children, and hopefully grandchildren, for many years to come.

Pregnancy is a time of changes. If your heart health is one of them, the Multidisciplinary Obstetric Medicine Services (MOMS) can help. Learn more about how we safely help you and your baby through pregnancy on our website. 

Lucia E. Larson, MD, FACP, Dipl.ABOM

Dr. Lucia Larson specializes in medical problems in pregnancy, including thromboembolic disease, preeclampsia, cardiac disorders, and diabetes, as well as obesity and lifestyle modification.