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congestive heart failure during pregnancy
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congestive heart failure during pregnancy

I am 24 weeks pregnant with an echo showing significant diastolic dysfunction. I am on lasix and a beta blocker.My cardiologist says my symptoms ( high heart rate, shortness of breath and fast weight gain) should subside as they are worst between 16 and 24 weeks of pregnancy. I had this condition happen during my last pregnancy but it was failed to be diagnosed until after I delivered and my lungs filled with fluid.After that episode I was treated with medicine for months and I had no more problems with my heart,even having my cardiologist saying this wouldn't happen again during another pregnancy but it is happening again. There seems to be very little literature about my condition so I would like to hear from anyone else thats had this happen...as to proper treatment ect. My cardiologist says that once I deliver my heart will return to normal. Is he right this time?
Avatar_dr_m_tn
Hello, I am really sorry that you are having this problem during your pregnancy. From what I understand of the description, you probably have some type of heart failure with preserved ejection fraction (diastolic dysfunction) that is probably compensated when you are not pregnant and that is why you don't have symptoms. The symptoms that you reported are related to the progressive increase of circulating volume in your blood vessels and the drop of the hematocrit (concentration of red blood cells) that are part of the pregnancy and overload your heart. The fact that you are on Lasix and you are probably still retaining water in your body means that you are eating too much salt or the dose of water pills is not adequate or your blood pressure is high. You should discuss that part of your treatment with your doctor. I think that is unlikely that your baseline problem will disappear after your pregnancy and you should have a full cardiologic workup 3-6 months after your delivery. The moment of the pregnancy that has the highest risk for a patient with heart disease is immediately post-delivery, when the volume of blood/water in the blood vessels increase very fast due to the contraction of the uterus and the squeezing of all its small vessels. You will need a tight control of your weight, cardiac parameters and medications, to prepare you for your delivery and avoid repeating and episode like the previous one.

Good luck
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