Exploring the cardiovascular effects of pregnancy

This post was written by William Collis, MD, PPG – Cardiology.

Pregnancy isn’t easy. This comes as no surprise to all the mothers out there, but what is surprising are the physiological changes that can occur within nine months. While we all know about the obvious physical fluctuations like an expanding belly, weight gain, swelling in the ankles, fingers and toes, it’s also important to focus on the lesser-known cardiac changes that can happen during pregnancy. Let’s take a closer look at the ways pregnancy can alter a woman’s heart and blood vessels:

• Increase in heart rate: A woman’s baseline heart rate may increase by 20-25% during pregnancy because the heart must work harder to pump more blood to the organs and uterus.
• Murmurs: Many women will develop a flow or innocent murmur while pregnant due to increased blood flow through the heart. They are common during pregnancy and usually benign.
• Anemia: During pregnancy, the volume of blood increases, which means iron and vitamins must also increase to make more red blood cells. If there isn’t enough, it could lead to anemia.
• Decreased blood pressure: This usually happens within the first and second trimesters but will rise again during the third. Many note a slow increase, back to near pre-pregnancy levels.
• Increased ectopy: With the increase in heart rate and neurohormones during pregnancy, extra heartbeats may be more noticeable.

Fortunately, the heart can generally adapt to the stressors and demands placed on it during pregnancy. However, some problems could arise and include:

• Peripartum cardiomyopathy (weakness of the heart muscle): A decrease in the ejection fraction or squeeze of the left ventricle can occur around delivery. It’s more common in African American women, those 30 years of age and older, and women who’ve had multiple pregnancies and hypertension. And, unfortunately, the cause is unknown.
• Arrhythmias: This is an abnormal or irregular timing or pattern of someone’s heartbeat. It can either be too fast or too slow. Rhythm disturbances can be more severe than the usual increase in heart rate. Be sure to consult your physician if you have questions or concerns.
• Gestational hypertension: This condition is a form of high blood pressure during pregnancy.
• Preeclampsia: This is a pregnancy complication characterized by high blood pressure with signs of organ damage (usually kidney or liver dysfunction) that occurs after 20 weeks of gestation.

The Parkview difference

The Women’s Heart Clinic at Parkview Heart Institute was created in 2020 to help educate and treat pregnant women (or those looking to become pregnant) who have preexisting cardiac conditions. We are proud to function as an adjunct to the OB/GYN or primary care provider and help care for those women who may have concerns about symptoms or findings during pregnancy. For more information, call 260-266-5680. Speak to your OB/GYN or primary care provider about a referral to the Women’s Heart Clinic at Parkview Heart Institute.