mitral valve and pregnancy

[Confused8]

I am a 25 year old who was diagnosed with mild mitral regurgitation with thickening of the leaflet and trace tricuspid regurgitation after an echo 2/2005.  Everything else was within normal limits.  I had been having some symptoms and was at the ER several times with chest pain, tachycardia and palpitations.  Since then I have pretty much been able to control all of the symptoms by cutting out caffeine.  I still do have some shortness of breath and palpitations at night.  I also suffered a bout of pericarditis in April 2005 after a viral infection.  I am considering getting pregnant soon and want to know how the mitral regurgitation will affect the pregnancy.  Will the symptoms get worse or will the regurgitation get worse (progress)?  I have read of sudden death with mitral regurgitation and pregnancy and it worries me.  Also, would the pericarditis have made the valve/regurgitation worse?  Should I get another echo before getting pregnant?  Also, what precautions should be taken during/after the pregnancy?  Thanks in advance!  I have found that your forum and expertise are a great help to many people.

[CCF-M.D.-MJM]

Hello,

Glad to read you thinking about pregnancy.

My simple advice -- if you have only mild MR, don't even give it a thought.  Mild MR will not be effected by pregnancy and the sudden death stuff does not apply to you.  If you have severe MR and a torn cord, then you should consider MVR -- this is the sudden death population, incidence 1% per year.  Erase this from your mind, it does not concern you, it will only make you worry.

Pericarditis does not cause/effect MR.

Unless your symptoms have changed dramatically, you do not need another echo.

If you have mitral valve prolapse, antibiotic prophylaxis is not necessary for uncomplicated pregnancies with vaginal or C section.  Your murmur may get louder during pregnancy, but this is usually not a concern, only an anticipated physiologic changes associated with pregnancy.

Good luck!!!!

[Bdette]

I am currently 22 weeks pregnant with tachycardia - prior to this pregnancy I also had MVP and tricuspid regurg. All I can tell you is that it gets worse with pregancy, tachy episodes are more frequent, more uncomfortable, with some shortness of breath. I have been holding off going on betablockers until the 3rd trimester. The palpitations are worse with each pregnancy. My first one wasn't this bad - but the murmur was worse and didn't recover until I was 1 year postpartum. It started up again and that's how I found out I was pregnant with the second one. I think with the increased blood volume, the valves work harder and cause the tachy episodes and worse murmur.

Is anyone pregnant on beta blockers? How do you feel on beta blockers? What about it's effects on the baby. Does anyone already how low blood pressure?

[ngkk]

I'm also currently pregnant - about 18wks.  I also have had multiple episodes of tachycardia with this pregnancy - which I did'nt with my first.  But - I am on beta blockers and have been with both pregnancies.  I currently take 25mg toprol - which is a 'C' catagory med.  I had absolutly no problems being on the toprol with the 1st pregnacy - both my cardiologist along with my OB both recommended it and oth approved 100%.  I also nursed my son the whole 1st yr on it also!  I do have a question maybe someone can answer - my heart rate has been around 100-110 throughout this pregnancy on and off.  They put me on an event monitor - but all came back ok except for the fact my heart rate was up - my cardiologist said there is nothing to worry about and go on - this is all going on being on 25mg of toprol! I am finding this awful hard considering how I feel when it is up.  Sorry to run on like this but this all makes me feel scared to death!!

[karen23]

I don't think 100 is that high for pregnancy.  My RHR is around 72 and during my pregnancies, it went up to about 85-90.  Depends on what your resting is, I guess.  Did you try deep breathing and relaxation techniques to lower.  Or it might be because of increased blood volume, which is probably why your cardio is not worried.  I had lots of PVCs with my last pregnancy, and I am almost 7 months post partum now, and just getting what seems like the tail end of them.  Same thing happened with my first.  I always put it down to hormones, as do many other women, but no one in the medical profession will concur with this.  I still believe it though!  Good Luck with your pregancy and try not to stress.

[ewiland82]

I also had tachycardia ( heartrate of 110-120 )and PVC's during pregnancy. My resting heartrate before pregnancy was always in the 90's though. I do not have mitral valve prolapse however. They thought I might when I started to have these symptoms. My PVC's reared there ugly head around 18 weeks of pregnancy also. They took 2 EKG's all was normal and also had me wear a 24 hour holter monitor which also showed up normal but sinus tachycardia and PVC's and PAC's. Only break I got of these blasted things was the last week of my pregnancy before I gave birth. I had very few PVC's before pregnancy maybe 3 a month ( but then I had no idea what they were ). I REALLY think they are hormonal. After the echocardiogram I had 3 months postpartum when my symptoms got ten times worse.. showed I had an EF of 60-65 percent ( perfectly normal ) and trace mitral and trace tricuspid regurgitation which I hear majority of the population has. I also had a trace aortic regurgitation but they said it was a very small amount and just to get an echo every 3-5 years to keep an update on it and to take antibiotics before any medical or dental procedure! Confused :  I also was told that pregnancy can put an increased workload on your heart and can cause your valves to leak...so I would be careful. I would definately get another echo before coming pregnant especially if you had pericarditis. My mom had that and congestive heart failure and has cardiomyopathy because of it. So be CAREFUL. I am not a doctor or nurse these are just suggestions. Goodluck!!

[ewiland82]

I hear ya on that. The palps cause alotta worry..lol. I worried myself to death. He offered me beta blockers but also said that the side effects can be worse than the palpitations thereself. So I took nothing and still do not take anything. I ignore it.

[ewiland82]

Oh yeah 100-110 isnt anything... they clocked my heartrate at 180 on the 24 holter monitor..as I was going up and down our stairs and cleaning. I also didn't see a cardiologist..my OB told me what was going on and if it was OK. And get this...I went in for my 8 month appointment and told them that these PVC's were getting really annoying and he said to excercise to keep up with them and they wouldn't be as noticable..boy was he wrong.

[Confused8]

Thank you doctor for your response.  It definitely does ease my mind.  Also, thanks everyone else for your comments!

[ewiland82]

Yeah that is what he said. But it  made mine worse. I guess it depends on the individual. I need to condition myself, I don't excercise nearly enough, that is probably the reason.

[angiedk77]

I am 28 and I too have mild mitral valve regurgitation and had a baby 6 months ago. I was diagnosed back in 2002, the cardiologist told me that since mine was mild that there was no reason to follow up with him. There's no reason for you to rule out becoming pregnant, it's such a wonderful experience. I had no complications during my pregnancy and I'm sure you won't either. I did however have to have a C-section, that was only because my pelvic bone wouldn't give, so the baby couldn't fit through. Try not to worry. From what my Dr.'s have told me, mitral valve reguritation is pretty common, a lot of people have it and don't even know it.

[melzieb]

I can't even believe I was fortunate enough to stumble upon this.  Usually I end up i nthe archives section.  Anyway, here's my story.... I have been having pvc's for a few years now.. maybe longer, but only in around 2003 did I realize what I was feeling.  I have worn 2 holter monitors, had several normal ekg's and most recently had an echo and an exercise stress test done (2/2005).  The last holter I wore in January of this year showed 3,000 pvc's in a 24 hr. period- though cardio feels they are benign.  I have since tried to relax about them.  Currently, I am a little over 11 weeks prenant and at around 10 weeks the pvc's returned with a vengeance- much more symptomatic than I ever remember feeling- sometimes 6 or so in a minute.  Another normal EKG and a 24 hour holter which showed around 1,000 in a 24 hour period.  My primary wants me to go cack to the cardio which has me freaked out.  She is trying to be reassuring though still tells me that it is an irregular heartbeat and we need to treat it as such.  She said they are "normal" PVC's and that everyone has them, but if it was up to her she would put me on a beta blocker.  She says it is not an emergency, but would like me to be seen at the cardio in the next week.  It's terrible, I know, but I just keep waiting to drop over from these things.  I lost a friend to ventricular fibrillation a few years ago and just cannot help but think that that's what these pvc's will lead to.  Any helpful info or reassurance is most appreciated.  I know everyone has their own story.  I wish you all well.  Thanks.

[cowgrlup]

I am 20 weeks pregnant and was diagnosed 3 years ago with Paroxysmal Atrial Tachycardia for which I take a beta blocker daily (10 mg).  Just recently started having more palps than usual, boy are they scary and start me on anxiety attacks every time.  Sometimes I can just ignore them but sometimes I worry and it just seems to make them worse.  Just wondering if anyone else has this diagnosis and if the pregnancy in the last trimester was troublesome or not.  I do not know what to expect, I haven't had really any bad episodes of tachycardia to this point, but worry that as the baby grows I will have more problems.  I have struggled with anxiety and heart issues for the past few years and it has really changed me- I know that stress also has a big effect on your heart and I've had alot of that lately too.  Guess that's all for now.

[pacingamy]

Wow, thanks to all of you putting your information and experiences out here. I have found it so helpful. I have a few heart issues (moderate mitral regurgitation, mild tricuspid regurgitation, pvc's, and a pacemaker) and whole heatedly agree that each pregnancy is different. I am 31 and on my third pregnancy. With the question of weather to be checked out before and to be monitored during pregnancy.. Even if it is mild regurg, I would do it. I think it is helpful to have a base line of your vitals and the regurgitation before you head in to the pregnancy. Also, I have found it helpful for my OB and cardiologist to have a relationship and good communication. My first two pregnancy's went well. In fact my palps improved while pregnant. I had easy labor and delivery with both. This time around I am having major fatigue and palps. I am wondering if anyone has had concern for low blood pressure and consider it something to watch for as a sign that your regurgitation may be causing problems for you and the baby? I am 24 wks along and at my OB check-up today my bp is 94/60. I am so tired and my palps are pretty bad. It is also getting harder to breath, more than with the first two. I had an echo early in my first trimester that came back with no cause for concern. I am wondering if the strain of the 2nd trimester is putting a toll on my heart that my mitral valve can not handle. My resting heart rate is good at around 80bpm.

Thanks again to all for helping me feel like I am not so alone.

[Molly S.]

This is my first time on this forum- Thanks to everyone- all your comments really help- First of all blessings and good health to us all- dealing with this mvp business is no fun- but thankfully it's dealable- Anyway- Just in the past few months I found out I have mvp with mild to moderate regurgitation- no enlargement. It has been one of my DREAMS to have a baby and now I'm concerned about doing anything to put more strain on my heart. I got the okay from my cardio dr. on pregnancy...but I'm still scared... Have any of you had syptoms (symptoms) that relly worsened after pregnancy? If so,do you need to take meds to mangage it? Thank you all!