Pregnancy and heart problems, implications?

  Hi.  I have had problems w/ chest pain, lt.-headedness, and fainting, along w/ palps., for about a year now.  After numerous tests, all that was found was mild aortic insuff., sinus tachycardia, incomplete right bundle branch block, and "runs of wandering atrial pacemaker".  I also had a positive tilt-table test.  However, my cardio. said none of these were causing my problems, and after trying verapimil (for possible vasospastic angina, ruled out by cath. w/ ergonovine), and basically we let it go at that.  My symptoms had been occuring up to twice per week, and had reduced to about twice per month. As for my question, I just found out I am 7 weeks pregnant.  My heart rate has been very high (90-100 bpm resting), and my bp low (95/60) for about a month now.  My cardio said there should be now problems w/ pregnancy, but I am concerned, especially since we never really came up w/ a diagnosis.  Also, my previous pregnancy (before having any of these symptoms) was difficult, w/ nausea and vomiting, and dizziness for seven out of the 9 months.  Should I seek a second opinion, or just go with what my cardio has said?  My midwife practice has labeled me "moderate risk", even though my cardio says there are no problems.  I'm confused. What do you think about all this?
  Thanks, Lori

[CCF CARDIO MD DLB]

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Dear Lori
It sounds like you have had several cardiac tests. It is pretty rare to find doctors that do ergonovine testing these days (we still do it occasionally). I doubt that the nausea and vomiting with the last pregnancy had anything to do with your heart. You could get a second opinion if it eases your mind, but it sounds like you have already had a mega-workup. Of course the midwives labeled you as moderate risk - who wouldn't after hearing all your different symptoms. However, that label does not make you moderate risk - your own cardiologist is in the best position to assess your true level of risk.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.