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Heart Disease  (Expert Forum)
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Pregnancy Following A Heart Attack
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.

Pregnancy Following A Heart Attack

by BabsD, Jan 23, 2002 12:00AM

I'm a 37 yr old woman who was diagnosed at 31 as having had a silent heart attack, although the doctors don't know when it happened. I was having PVCs(benign), which I mentioned to my Internist during a routine exam. An ekg showed abnormal results, and an echo showed a small area of damage. I next had a thallium stress test, and a heart catheterization showed damage from a moderate heart attack, although I had normal coronary arteries. I had taken the Pill for 5 yrs prior to diagnosis, and my cardiologist is assuming that the MI was caused by a blood clot, possibly related to the pill, although I guess I will never know for sure what caused it.

I've had several echos and stress tests since diagnosis, with no change.I don't smoke or take drugs, drink rarely and am otherwise healthy,although I am 40 lbs overweight. My EF is 50, blood pressure normal, all other tests have come back negative/normal: clotting/coagulation tests,diabetes,lupus, Lyme,excess iron,hepatitis,HIV, lipoprotein a, anti-phosholipid antibody, anti-nuclear antibody tests,etc. I currently take 1 mg folic acid, 81 mg aspirin, 25 mg atenolol, fish oil and a multivitamin. My total cholesterol:186, HDL:43 LDL:130 Trig:68.

I want to get pregnant soon, and would like to know what the risks would be. None of my doctors could give me any statistics since they said that I am a rarity. What would be the risk of another blood clot? Would I be at an increased risk of peripartum cardiomyopathy? Would I need certain tests done or a special type of delivery? Any info you could give me would be greatly appreciated.

by CCF-M.D.-CRC, Jan 23, 2002 12:00AM
Dear babs,
First, I am not sure that you had a heart attack.  I would have to see the tests myself but it is possible you may have had instead a myocarditis (inflammation of the heart) with focal damage.   Were you smoking at the time you were taking birth control pills?  If so this may have increased your blood clot risk.  

There are no statistics for heart attack during pregnancy but I would think you are at a very low risk of having a heart attack (even if the first even was a heart attack) during pregnancy.  There is no known increased risk of peripartum cardiomyopathy in individuals with prior heart attacks. Your OB should be aware of your history and may wish to check an echocardiogram during pregnancy.
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