Pregnancy-related heart attacks in the news…

Cardiovascular disease (heart attack & stroke) is now the leading cause of pregnancy-related death. Pregnancy may increase the risk of heart attack by as much as 3- to 4-fold. While it is still a quite rare occurance, it is obviously devastating, and thus, very important to understand and prevent.

While some risk factors for heart attack are not within our control (like age), some absolutely are. Risk factors that are modifiable (meaning we can change or improve them) include

• being above ideal body weight

• diabetes

• high blood pressure

• smoking

• high cholesterol

Pregnancy complications like gestational diabetes, gestational hypertension (high blood pressure) and pre-eclampsia are leading causes of pregnancy-related heart attack and stroke and are often related to placental issues; however, many of these above conditions make these complications more likely. Discussing with your provider how to safely treat these diseases through nutrition and other lifestyle changes, ideally prior to pregnancy, but even during it, is of utmost importance.

Additionally, women need to be aware that even though they are young, heart disease can and does happen.

Today we spoke with Verywell Family regarding a recent study that found increasing rates of pregnancy-related heart attacks in young women. Dr Harkin commented

Cardiologist Dr Nicole Harkin advises pregnant women to watch out for common signs such as chest pain, shortness of breath, and unexplained fatigue with walking.

“Some of these symptoms, like fatigue, can be normal in pregnancy - regardless, reporting them to your doctor, especially if you have risk factors for heart disease, is always recommended,” advises Harkin.

She encourages all women to not be afraid to speak out and demand attention and care relating to their health. “Being a strong advocate for yourself cannot be underestimated... as individual women, if something feels wrong, we need to make sure our voices are heard.”

Proper identification and treatment of heart disease before it leads to a bad outcome is key. In this study, the most common time for a heart attack to occur was postpartum, so be mindful that these things can happen in the immediate period after having the baby.

There are also systemic issues at play underscored by the fact that insurance status and Black race were also risk factors identified in this study. The burden is on the healthcare system to fix these social determinants of health - the first step of which would be the implementation of cardio-obstetric teams nationally as well as increased availability of preconception counseling.