Spotlight On: Pregnancy and heart disease

"Can someone with heart disease still get pregnant and have a baby?"

James Bergin, M.D., a University of Virginia Health System cardiologist, answers this month's question:

Many women with heart disease can successfully have children. The factors to be considered are the cause of the heart disease, the overall pumping capacity of the heart and the status of the heart arteries. For women with heart disease caused by pregnancy, we do not recommend future pregnancies even if their hearts have recovered, as the recurrence rate of the heart failure is about 30 percent.  

Women with moderate heart failure signs or symptoms, or those with transplants should also avoid pregnancy. Women who need to stay on cholesterol-lowering medications or a class of medications called ACE inhibitors or ARBs should also not have children as these medications can injure the developing child. One other difficult issue to consider is that if the mother’s heart disease is significant enough to limit the mother’s survival, how will the family do without them?

The bottom line is, think of having children as one long (never ending) stress test.  Women with mild to moderate heart disease, who can tolerate changes in their medications and who would do well with such a stress test, can safely have children.  Make sure you ask your physician directly about this issue.