heart disease online : Heart Diseases resource HEART DISEASE ONLINE : Your resource for current and reliable information about HEART DISEASE.  It's so simple, even your child can understand !
Heart Disease information EVEN your child can understand !

Heart Disease articles heart disease articles
Heart Disease resources
Heart Disease reports heart disease reports
Heart Disease guides heart disease guides
Heart Disease books heart disease books
Heart Disease news heart disease news
Congenital Heart Disease congenital heart disease
Coronary Heart Disease coronary heart disease
Rheumatic Heart Disease rheumatic heart disease
Ischemic Heart Disease ischemic heart disease
acute coronary syndrome acute coronary syndrome
high cholesterol levels high cholesterol levels
smoking cessation quit smoking
aerobic exercise at home aerobic exercise at home
what is hypertension what is hypertension
Heart Disease Online heart disease online
heart disease facts heart disease facts
Signs of a Heart Attack signs of a heart attack


home / ARTICLES You Are Here Now Heart Valve Disease Coronary Artery Disease Congenital Heart Disease Congenital Heart Disease
HEART DISEASE ONLINE - Your resource on Heart Disease - all about the heart written in such a simple manner, EVEN your child can understand !
Heart Disease Articles
- By your Heart Disease Online guide photo of your guide to Heart Disease

Have a suggestion ?
Offer A Heart Disease Suggestion
Click here to
Tell the Doc

State of the Heart

Heart Fitness for Life : The Essential Guide to Preventing and Reversing Heart Disease

A Practical Guide
to YOUR Heart
and Heart Surgery

Click For More Info

Stay Informed

Join our mailing list.
Get the latest heart news by e-mail.


Heart Disease in Pregnancy - The Risks

Pregnancy is one of the physiological conditions that places a considerable burden on the heart, forcing it to work harder for a significantly long period - nine months. While a normal heart is quite capable of taking this extra workload right in its stride, a diseased one may not be able to cope. Different kinds of heart disease may cause different problems during pregnancy. In this series of articles I plan to discuss this topic in depth.

Risk during pregnancy to the mother with heart disease

Pregnancy poses an inordinately high risk for mothers with heart disease in conditions where blood flow into the lungs is obstructed. The block may be at the

  • inlet to the lungs, the pulmonary valve e.g. pulmonary stenosis
  • outlet from the lungs, the mitral valve e.g. mitral stenosis

In both of these situations, blood flow into the lungs does not keep pace with the increased flow to the rest of the body imposed by the pregnant state.

The diseases which are associated with the highest risk to the mother during pregnancy are:

  1. Eisenmenger syndrome (severe pulmonary hypertension as a consequence of a long standing left to right shunt lesion like ASD, VSD or PDA) in which the maternal mortality risk is as high as 30-50%
  2. Primary pulmonary hypertension, a disease of unknown cause that increases the resistance to blood flow in the lungs
  3. Cor pulmonale, a disease of lung blood vessels secondary to smoking or other lung fibrosing illnesses
  4. Pulmonary venous occlusive diseases which block the outflow of blood from the lungs back to the heart

Among the congenital heart diseases, Tetralogy of Fallot carries a risk of 4 to 20% of mortality in the mother. Atrial septal defects are perhaps the safest of all birth defects. Even with more the serious conditions, obsessional care can reduce the risks considerably.

Rheumatic heart valve disease is another risk, with patients having mitral stenosis having a 1% chance of developing pulmonary edema during pregnancy. Other diseases like Ehlers Danlos syndrome (a disorder of the connective tissue of the body resulting in loose skin and lax joints) can cause a higher risk of bleeding from major blood vessels that might rupture during pregnancy.

Risk to the fetus during pregnancy with heart disease

In mothers with rheumatic heart valve disease, the fetus develops almost normally. The only difference noted is a mild growth retardation, with babies being lighter by around 200 grams.

In mothers with congenital heart disease too, pregnancy is almost normal in diseases without cyanosis. However, in cyanotic mothers, many problems like severe growth retardation and higher abortion rates arise. Because the maternal blood has a very low oxygen content, there is a lower oxygen exchange across the placenta, and the fetus gets lesser oxygen than normal. As a result, the fetus dies or is delivered prematurely. The situation is however reversed after surgical correction is done.

Coarctation of the aorta is another special condition, in which fetal loss is higher than normal (13%) as a result of lower blood flow to the placenta due to the narrowed aorta.

Will the fetus also develop congenital heart disease ?

A question most parents who themselves have birth defects will ask their doctor is "Will my child also have CHD ?" The risk of congenital heart disease in such pregnancies is 2-4 %, which is twice the incidence of heart disease in the general population. This risk also varies with different conditions. For instance, it is 3% in parents with Tetralogy of Fallot but almost 18% in those with Aortic Stenosis.

Another interesting fact is that such defects are concordant - that is, the defect in the child is usually the same one as of the mother. Importantly, if the mother's defect was one caused by an external factor - for example, by exposure to a drug, or an infection with German measles during gestation - then the fetus of such a person would have a risk of birth defects SIMILAR to the general population only.

In the next article, we will see how congenital heart disease affects the pregnancy.

home / ARTICLES You Are Here Now Heart Valve Disease Coronary Artery Disease Congenital Heart Disease Congenital Heart Disease





Heart Disease Online does not provide medical advice, diagnosis or treatment. Material on this site is provided for informational purposes only. The site is not intended to supply personalized answers or advice to patients. It is not meant to be a substitute for professional medical advice. The information should not be used to diagnose or treat a health problem, disease, or to prescribe any medication. In case of doubt, promptly contact your health care provider. Never disregard professional medical advice or delay seeking it because of something you have read on Heart Disease Online. Click here for additional information and to read the full disclaimer and terms of use

Comments are welcome

Copyright © 1997-2013 Heart Disease Online , All rights reserved.
Terms of Use | Privacy policy | Disclaimer

Text, graphics, and HTML code are protected by US and International Copyright Laws,
and may not be copied, reprinted, published, translated, hosted, or otherwise
distributed by any means without explicit permission. Legal notices

Heart Disease Online (tm)
663, 99th Street, Madras, TN 60107
Fax : (603)-908 4676     E-mail : webmaster@heartdiseaseonline.com
URL : http://www.HeartDiseaseOnline.com