Heart Disease in Pregnancy: Why Specialized Care Matters

Medically reviewed by: Dr. Tom Babu, Consultant Diabetologist & Endocrinologist - Written by Riya Yacob - Updated on 15/5/2025

Specialised care matters because pregnancy forces the heart to work much harder to support a growing baby, and this makes expert supervision necessary for anyone with a cardiac condition. When a woman is expecting, her blood volume increases by nearly half, which puts extra strain on every valve and chamber and this physical shift can reveal hidden issues or worsen existing ones. Having a dedicated pregnancy heart team ensures that these changes are monitored closely, and allows for a safe delivery and a healthy start for the child. 

Managing heart disease in pregnancy requires a deep understanding of how cardiovascular health interacts with hormonal shifts. Some women enter pregnancy knowing they have a condition, while others might find out during their first trimester. In either case, the goal remains the same, thereby ensuring the body can handle the increased workload without experiencing failure. From the first few weeks to the postpartum period, by involving specialists early, we can map out a plan that covers every stage.

Heart Disease in Pregnancy

The cardiovascular system undergoes a total transformation during these nine months, and to pump blood to the placenta, the heart rate climbs, and the amount of blood pumped per minute increases by thirty to fifty per cent. However, if the heart is already struggling or has a structural defect, these changes can lead to serious health issues.

Many complications are avoidable if the right support systems are in place, and improving maternal health outcomes depends on identifying risks before they turn into emergencies.

Many patients are worried about how their bodies will cope, and no doubt that it is a valid concern. As you might know, the heart works harder when you are sleeping and while you rest, and this constant demand means there is very little room for error. Understanding the mechanics of these changes helps us prepare for the different stages of labour and the sudden shifts in fluid levels that happen immediately after birth.

What are the Common Heart Conditions During Pregnancy?

Not all cardiac issues are the same, as some are present from birth, while others develop later in life or specifically because of the pregnancy itself. 

One common issue is peripartum cardiomyopathy, a type of heart failure that happens near the end of pregnancy or shortly after delivery. The heart muscle weakens, and this makes it difficult to circulate blood. Another frequent concern involves heart valve problems, and if a valve is narrowed or leaking, it might not handle the extra blood volume well, which can lead to fluid backup in the lungs.

Preexisting Heart Conditions that Could Affect Pregnancy

Many women with congenital heart disease conditions live normal lives and can have successful pregnancies, but it is important to note that they need extra care. Structural issues like a hole in the heart or repaired valves can behave entirely differently under the pressure of pregnancy.

Other preexisting conditions include:

• Chronic high blood pressure that existed before conception
• Arrhythmias, which are irregular heartbeats that might become more frequent due to stress and hormonal changes
• Hypertrophic cardiomyopathy
• Previous history of rheumatic heart disease

At Silverline Hospital, we review your full medical history to see how these conditions might react to your changing body. This involves checking how your kidneys are functioning and how your lungs are coping, as every organ system is linked.

Why Specialised Cardiac Care is Essential?

Standard obstetric care is wonderful for a normal pregnancy, but it isn't always enough when the heart is involved, and this is where a pregnancy heart team becomes a necessity. This group usually includes a cardiologist, an obstetrician specialising in high-risk cases, and also an anaesthesiologist. 

One of the biggest parts of this care is blood pressure management, as high blood pressure can lead to preeclampsia, a condition that affects both the mother and the baby. By keeping levels stable through safe medications as well as lifestyle adjustments, we reduce the risk of early delivery or growth problems for the infant.

Specialised care also means having a clear delivery plan, and we decide in advance whether a vaginal birth or a caesarean section is safer based on the heart’s ability to handle the strain of contractions. We also plan for the third stage of labour, which is when the baby is out, and the body undergoes a massive fluid shift. 

5 Warning Signs Pregnant Women Should Not Ignore

While some discomfort is normal during pregnancy, certain symptoms indicate that the heart might be struggling, and it is better to check and find nothing wrong than to ignore a signal that something is amiss.

Extreme Shortness of Breath

If you find it hard to breathe while resting or if you wake up gasping for air at night, it could mean fluid is building up in your lungs

Chest Pain

Any pain, pressure, or discomfort in the chest area during physical activity or rest should be reported immediately

Fainting or Severe Dizziness

While occasional lightheadedness happens, losing consciousness or feeling like the world is spinning frequently can indicate a drop in blood pressure or an irregular heartbeat

Rapid or Irregular Heartbeat

 
If your heart feels like it is racing, skipping beats, or thumping hard in your chest for no apparent reason, it needs an evaluation as soon as possible

Sudden, Excessive Swelling

Some swelling in the ankles is common, but if your face, hands, or legs swell rapidly over a day or two, it could be a sign of heart strain or preeclampsia

Always remember that early intervention is the most effective way to prevent pregnancy complications from becoming life-threatening.

Treatment & Pregnancy Management Options

Managing heart disease in pregnancy is very important, and this often involves adjusting medications as well. Some heart drugs are safe, while others can interfere with how a baby grows, and we spend time finding the right dosage and type of medicine to keep you stable.

Regular foetal monitoring is a large part of our process, and we use ultrasounds to check the baby’s growth and blood flow through the umbilical cord. If the mother's heart isn't pumping efficiently, the baby might not get all the nutrients they need, and by keeping a close watch on the baby, we can decide if we need to change our approach to the mother's treatment.

While we usually encourage movement, some women with heart conditions might need to limit strenuous exercise, and we provide specific guidelines on what is safe for your particular situation. We also focus on nutrition, and this ensures you get enough iron and keep your salt intake at a level that doesn't cause extra fluid retention.

Conclusion

Carrying a child when you have a heart condition requires extra steps, but with the right help, it is manageable. With a pregnancy heart team, the focus will be on early detection, careful monitoring, as well as a coordinated delivery plan.

If you have questions about heart disease in pregnancy or want to know more about our specialised services, please get in touch with Silverline Hospital.

Frequently Asked Questions (FAQs)

Q1: Can I have a natural birth if I have a heart condition?
A1: Yes, many women with heart issues can have a vaginal delivery, and we often prefer it because it involves less blood loss and a lower risk of infection than surgery. However, we sometimes use an epidural early to keep your pain and stress levels low, which helps keep your heart rate steady, and the final decision depends on how your heart is performing as you get closer to your due date.

Q2: Will my baby be born with a heart problem if I have one?
A2: There is a slightly higher chance the baby might have a heart defect if a parent has congenital heart disease, but it is not a certainty. Most babies are born with perfectly healthy hearts, and we also use detailed foetal echocardiograms to check the baby's heart structure while they are still in the womb so we can be prepared for any situation.

Q3: Is it safe to take heart medication while I am pregnant?
A3: Many heart medications are safe, but some are not. If you are already on medication, we will review it immediately. We might switch you to a different drug that has been used for a long time in pregnant patients and is known to be safe for the baby. You should never stop taking your heart medication without talking to us first, as stopping suddenly can be more dangerous than the medicine itself.