Life-threatening disease affects mothers and babies

Finding out you are pregnant can be one of the most joyous times of a couple's life.

However, a potentially devastating disease affecting young, healthy women could take that all away.

It is the call Dr. Stephanie Dunlap never wants to get.

She says, "It's always my most anxious moment as a heart failure physician because I have the chance to lose two patients instead of one."

It’s the moment that almost took Amanda Hodge's life at 28 and pregnant with her second child. Something did not feel right.

Amanda says, "Doctor after doctor kept saying, 'You're pregnant honey. You're going to have swelling. You're going to have trouble breathing. You do get tired easy.'"

At 24 weeks, her water broke. She was put on bed rest. Then, three weeks later, she underwent an emergency c-section.

When her heart suddenly stopped beating, what was the cause?

It was peripartum cardiomyopathy, a form of heart failure that affects healthy women during the last months of pregnancy, or up to five months after delivery. It happens in about one in every 3,500 pregnancies. Twenty-five to fifty percent of affected women will die. Since the symptoms mimic pregnancy, it is often not diagnosed.

However, Dr. Dunlap knows some warning signs. She says, "You develop ankle swelling to the point you can stick your thumb in and leave a dimple, that's 2 millimeters or more deep, and you hear yourself wheezing, and you're having to sit up at night to breathe."

While Amanda's life was saved, babt Gideon Lew did not make it. Now, Amanda wants to warn others about the condition.

She says, "The fact that I'm here at all is an absolute miracle, and I won't take that for granted."

Women who develop peripartum cardiomyopathy run a high risk of death with future pregnancies, and doctors warn against trying to get pregnant again.

RESEARCH SUMMARY

HEART FAILURE AND PREGNANCY: Cardiac diseases complicate one percent to four percent of pregnancies in women without preexisting cardiac abnormalities. If a woman has preexisting symptoms of cardiac disease than they should inform their physician so the proper procedures can be taken to protect mother and baby. Pregnancy stresses a woman's heart and circulatory system. During pregnancy, the woman's blood volume increases by 30 to 50 percent to nourish the growing baby. The amount of blood the heart pumps each minute also increases by 30 to 50 percent as well as the heart rate. These changes cause the heart to work harder. Also labor and delivery add to a heart's workload. During labor - particularly when pushing - the pregnant woman will experience abrupt changes in blood flow and pressure. When the baby is born, decreased blood flow through the uterus also stresses the heart. Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the final month of pregnancy or within 5 months after delivery. SOURCE: (www.clevelandclinicmeded.com); (www.mayoclinic.com); (www.ncbi.nlm.nih.gov/pubmedhealth)

CAUSES: Peripartum cardiomyopathy occurs when there is damage to the heart. As a result, the heart muscle becomes weak and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems. In the United States, peripartum cardiomyopathy complicates 1 in every 1,300 - 4,000 deliveries. It may occur in childbearing women of any age, but it is most common after age 30. SOURCE: (www.ncbi.nlm.nih.gov/pubmedhealth)

RISKS: Risk of heart failure depends on the nature and severity of the underlying heart condition. For example: heart rhythm; issues with the heart valve, such as an artificial heart valve or heart or valves are scarred or malformed; congestive heart failure; or having a congenital heart defect. SOURCE: (www.mayoclinic.com)

SYMPTOMS: Some signs of heart disease are: difficulty breathing, fainting, heart palpitations, rapid heart rate or irregular pulse, chest pain, and a bloody cough or coughing at night. SOURCE: (www.mayoclinic.com)

PREVENTION: Taking care of oneself, with proper exercise and diet is the best way to prevent heart disease and to have a healthy baby. For example: keeping prenatal appointments; taking medication as prescribed; getting plenty of rest; monitoring weight; managing anxiety; and of course avoiding smoking, alcohol, and illegal drugs during pregnancy can all limit the risks of heart failure. SOURCE: (www.mayoclinic.com)


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