Pregnancy and heart risk

[fearfactor]

I am around 6 weeks pregnant with my second child right now.  I'm a 33 year old female in good health.  I have a history of PACs and PVCs and severe anxiety attacks.  I am presently getting off 1 mg of Xanax per day by titrating down .25 mg every 5 days.  It has proved very difficult but I am getting by.

My question relates to heart risks of pregnancy.  With my last pregnancy, I had PVCs toward the end, but was also drinking large amounts of caffeine at the time.  That was 5 years ago.  Since then, I've developed more frequent PACs and PVCs, caught on a holter monitor.  I have actually noticed their frequency becoming less since I've found out I'm pregnant.  I am concerned, however, that pregnancy hormones can cause an increase in PACs/PVCs.  Is this true, generally?  In the worst case scenario of my developing large numbers of PACs/PVCs a day, what are my risks for cardiomyopathy?  I understand that cardiomyopathy during pregnancy and after delivery is a risk all pregnant women face.  Is this the case?

Additionally, I understand there is a risk of developing supraventricular tachycardia during pregnancy.  What are the risk factors for this?  Is frequent PACs/PVCs one of them?  What are my risks for atrial fibrillation with frequent PACs?  I've read that frequent PACs often precede AF.  I understand, however, that since I am young, have very low BP and no coronary artery disease, my risk of AF is low.  Is that right?

My BP has been running low - it can get down to 87/58 or so.  Is that too low?  I don't really feel any significant dizziness.  Thanks for your help!

[CCF-M.D.-MJM]

Hi Fearfactor,

Congratulations on your pregnancy.  You have been through it once so this time should be easier on you.  The biggest thing you need to worry about is your worrying.  Your risk of cardiac problems with pregnancy based on what you wrote is VERY low.

Is this true, generally?

I have had people tell me that pregnancy increases and other tell me that it decreases their PVCs/PACs.  there is no way to guess.  The important point is that even if you pvc/pacs increase, your cardiac risk is still very low.

In the worst case scenario of my developing large numbers of PACs/PVCs a day, what are my risks for cardiomyopathy?

VERY low.  So low that I wouldn't even consider it.

I understand that cardiomyopathy during pregnancy and after delivery is a risk all pregnant women face. Is this the case?

It is true that all women are at risk for a post partum cardiomyopathy, but here are high risk groups like african americans, twin pregnancy or multiple gestations, and most importantly history of prior post partum cardiomyopathy.  You don't have these risk factors.

What are the risk factors for this? Is frequent PACs/PVCs one of them?

If you haven't had an SVT before, you are at no great risk now.  PACs/PVCs often are the initiating event for arrhythmias, but you would probably know by now if you have a substrate for a SVT.
What are my risks for atrial fibrillation with frequent PACs?

I understand, however, that since I am young, have very low BP and no coronary artery disease, my risk of AF is low. Is that right?

You are correct.

Is that too low?  Nope, not as long as your organs (kidneys, liver, heart) are getting enough blood.  Your blood pressure is fine.

I hope this helps.  This is easy for me to say, but try not to worry to much about things that haven't happened to you.  I commonly see people in clinic with concerns like this and I am afraid that it affects their overall happiness.  Try to live in the moment -- Thanks for posting.

[fearfactor]

Thanks for your reassuring comments!  I am hopeful this pregnancy will go well and am sure it will!

[fearfactor]

Thanks for your reassurance!  Congratulations on your new baby!  Wow, I would've been freaking out over that false positive result.  I'm glad everything turned out fine!  :)