what's with females having babies and heart problems

Pretty much every single female I talked to that had kids has weird heart rhythm episodes...i'm really bothered by this because i think there should be more information on pregnancy and how it affects your heart during and after pregnancy....i started getting frequent one minute heart-pace-went faster episode after my first...and then after my second child i got SVT and PAC constant...i tired of doctors saying it's anxiety....no no no because pregnancy puts a big strain on your body and after you have the baby your body is trying to get back to normal and that unfortuntely includes your heart...but what causes this???  hormones? digestive system?  not having enough blood volume?
just tired of the lack of information that's all...  :(

[rosetoes]

Sorry to hear about your problems during and after childbirth.  For me, that wasn't the problem.  My SVT began way after child birth...my kids are 18, 16, 6 and I didn't start having SVT until now.  I do suffer with anxiety but that isn't what brings on my SVT.  Both episodes that I had an SVT episode, I was calm, cool and collective.  That is the worse part for me is the unpredicatibility of SVT...you never know when it's going to happen.  

I have read though that since your body carries more blood during pregnancy, you can experience PAC...I just didn't.  

Hopefully things will settle down for you and heart will calm itself. Good Luck.

[ARHMOM]

I just wanted to say that I am in the same boat.  I started having PVCs since I was 5 months post partum (4 months now).  My cardiologist has no explanation for me...it stinks because I am sick of this and I wish there were answers.  I take comfort knowing that this seems to be a fairly common and usually benign problem.  I hope that you can get the information that you want!

[aussie mum]

Hi i agree with your post big time !! Two week after the birth of my third child i started have pac/pvc and svt. Many trips to the ER dep with no real answers as to what or why this was happening. Once i was even told i was having a heart attack. So with that in mind what do i do ?? FRECK OUT that's what !! which just made them heaps worse :{

Thankfully in the end a wonder-full very caring understanding cardiologist came to my rescue with answers and reassurance. I had a mild form of PPCM which fixed itself without needing any med. I still however get these crappy things and will more the likely always have them. What i find hard is when i don't having any for days/weeks then THUD there back :{

Do you think it can be due to hormones ?? My cardiologist was very up front with me saying that every case should be treated differently even with all of the information that is out there they are still unsure as to why they happen.

What do you think sets your off ?? I seem to get them more when doing nothing (when my heart rate slows down) or laying on my left side. Did you have them bad during your pregnancy?? How long do your svt last for and what do you do to revert them ?? Sorry about all the question but i find peoples post/anwsners very good medince for me (LOL)

THANKS KINDLY

[hltyhrt]

i too started with hrt palps after my first child 12 yrs ago. I used to have them every so often but now get them more frequently, I think because my anxiety has gotten so bad~ leading to panic attacks over the past yrs. I too asked my MD about the relation but was told not sure. I have had an holter and it picked up pac/pvc's. So I definitely can relate.

[deedle1976]

My PVCs started when I was 7 months pregnant. I'd always had a few here and there but one week just started getting 6 per minute and the never went for more than 2 minutes without a PVC for the rest of the pregnancy. On a good day I had 1786 recorded. They decreased after pregnancy to a few hundred per day. i'm now 6 months postpartum and with the help of a beta blocker I've got them down to between about 6 and 100 per day. There are some scientific papers written on this subject where they have put holters on women who were suffering palpitations during pregnancy and found that they were having thousands of PVCs per day. After pregnancy they reduced by 95% for most women however a small minority contunued to have as many pVcs as before (although they did stop having couplets and VT). The authors of this study suggest the arrhythmias are due to the increased workload of the heart in pumping almost twice as much blood as usual. Also that they are due to increased sympathetic tone in pregnancy.  They determined that te PVCs come from the right ventricular outflow tract and they are catecholamine (adrenaline) dependant so they tend to respond to beta blockers.

Peripartum cardiomyopathy is caused by something else. Very recent research published just 6 months ago has shown that this is due to prolactin, the hormone responsible for lactation whicn increases at the end of pregnancy and after birth. Some women have a mutation in the prolactin gene which makes them produce a  faulty version of prolactin that damages the heart and capillaries. Trials in the very early stages have shown that taking a prolactin inhibitor called bromocriptine prevents PPCM. This is the drug they used to give routinely to dry up your milk so it is already established as a safe drug. If this is confirmed by further trials this discovery is fantastic. Not only will it save lives but it also means that women who have already had PPCM can have another pregnancy without damaging their heart.

[degrassi]

are you saying that post partum cardiomyopathy only occurs in women who nurse their children??

[degrassi]

Every mother you know has "weird heart rhythm episodes"??

[nikgirl28]

a lot of mothers i talked to have weird heart rhythm episodes...some refer them as panic attacks to post pardum depression...cause that is what we are being told they are...only we know that it's a heart rhythm that causes panic attacks and depression...i have hardly had any pvcs..never had pacs and definitely no svt until after my pregnancy...i heard of one woman on another health board whom went into a-fib for 3 days 2 weeks after her baby was born....something is up with our post pardum bodies for sure....

[aussie mum]

Wow.... hopefully this recent discovery on PPCM will shed some light for the doctors out there !! It sound thes-able but i do wonder why i only got it after the birth of my third child ??

Thanks for your great post !!

[anacyde]

That information on PPCM and prolactin from that study is extremely misleading.  That info was gathered using rats that were genetically altered to develop peripartum cardiomyopathy (PPCM) thus the results of that experiment cannot be taken as perfect, not by any stretch of the imagination.  At best it offers ONE possibility of many.  Bromocriptine is no longer given to women because of serious associated health risks - including the development of cardiomyopathy.  So you see, there are flaws, serious ones, on that study.

The most current information on PPCM shows that autoantibodies and viruses are present in many PPCM patients.  It is thought that having an autoimmune predisposition, or contracting a cardiotropic virus during the immune-suppressed state of pregnancy, can contribute to pregnancy-related heart failure.  Most of these women recover with standard heart failure treatment - not with Bromocriptine.  Some women go on to have successful subsequent pregnancies - MANY more than previously thought.  The key seems to be early detection and initiation of heart failure medications.

As to the question of why the rhythm issues present themselves after childbirth, I don't know.  I was fine after my first child was born, but I have been plagued with PACs and SVT since the birth of my second.  I know there are a lot of us, and the only thing that seems common is hormonal changes.

[anacyde]

For the best and most current info, keyword for "Fett, JD PPCM" and you'll find lots.

[Pum]

My heart rhythm problems started a few weeks into my first pregnancy. My theory (and I read something along these lines somewhere but don't quote me) is that the increase in volume of blood in pregnancy changes the heart a bit. Then when the blood volumes return to normal the heart is a bit more sensitive to electrical disturbances. Combine that with any PPD which magnifies focus on health issues and you have the recipe right. Not to mention blood sugar variations while breast feeding and hormones plus your thyroid goes a bit wacky after childbirth.  

All totally worth it in my book.

[degrassi]

OK ....so a lot of women get wacko after they have babies....is that the point?   And that causes their hearts to be irregular?  It is an outcome of post partum depression??  Nursing or not?  I am really intrested in this, and I am not being sarcastic.

[aussie mum]

Well it could be so.... Post partum depression vs ppcm i got both for the first time after the birth of my third. So now do i wonder would i have got one without the other ??

Guess i'll never know !!

[deedle1976]

Hi degrassi,
Women who don't breastfeed get PPCM as they too have a surge in prolactin towards the end of pregnancy and then a massive release of the hormone right after birth. It is this that likely does the damage as the end of pregnancy or early postpartum is the time that PPCM usually rears its ugly head. This theory is not yet proven though. They discovered by accident that PPCM in mice was caused by faulty prolactin and hypothesized that the same thing was responsible for PPCM in women. This led them to treat women with previous PPCM with bromocriptine during their second pregnancies. None of the women taking the drug developed PPCM whereas most of the drug-free women did, which supports the prolactin hypothesis. This was only published in February 2007 and more trials are needed.

I do wonder if prolactin levels remain elevated longer in breastfeeding mothers and if they have greater heart damage as a result. I don't know if this is the case. It's very interesting I think.

[degrassi]

but then why do so many women breast feed and not get PPCM?  Or why after one pregnancy and not the one before?

are you over PPCM, Aussie.  what was your ef?  I imagine you took the usual meds, but I am wondering if you had to stop nursing when you took the meds.

[deedle1976]

Hi Anacyde. Just saw your post. I will have a look at some of the other papers on the subject. I just came across the Hilfiker-Kleiner Cell paper when it came out in 2007. It's one of the hundreds I've had to read as part of my job and I must admit I haven't had a chance to read the paper properly or look at it since but it really stuck in my mind.

[deedle1976]

There's a good chance that, as with most things, there are multiple factors involved; genetic, environmental etc.

As anacyde said the study published in cell regarding the role of prolactin was conducted in rats  (apart form the small bromocriptine trial which was in women aswell). To further invetigate the prolactin theory they need to sequence the prolactin genes of a large number of PPCM women. The abstract is below.


A cathepsin D-cleaved 16 kDa form of prolactin mediates postpartum cardiomyopathy.


Department of Cardiology and Angiology, MHH, 30625 Hannover, Germany. hilfiker.

Postpartum cardiomyopathy (PPCM) is a disease of unknown etiology and exposes women to high risk of mortality after delivery. Here, we show that female mice with a cardiomyocyte-specific deletion of stat3 develop PPCM. In these mice, cardiac cathepsin D (CD) expression and activity is enhanced and associated with the generation of a cleaved antiangiogenic and proapoptotic 16 kDa form of the nursing hormone prolactin. Treatment with bromocriptine, an inhibitor of prolactin secretion, prevents the development of PPCM, whereas forced myocardial generation of 16 kDa prolactin impairs the cardiac capillary network and function, thereby recapitulating the cardiac phenotype of PPCM. Myocardial STAT3 protein levels are reduced and serum levels of activated CD and 16 kDa prolactin are elevated in PPCM patients. Thus, a biologically active derivative of the pregnancy hormone prolactin mediates PPCM, implying that inhibition of prolactin release may represent a novel therapeutic strategy for PPCM.

[deedle1976]

Ok sorry, just read that back again. the mutation is not in the prolactin gene itself but in an upstream regulator and affects the way the prolactin protein is cleaved.

[degrassi]

so women who don't nurse never get PPCM?  Oh, from the last trimester?  There must be much more going on, because I got DCM, and I have had a few kids with no problem, and nursed them all.

[deedle1976]

I don't know if the development of PPCM is affected by nursing. If the prolactin theory does prove to be true I would imagine that anyone could get PPCM. As far as I know everyone gets a surge of prolactin whether they breastfeed or not.  I'm not sure though as it's not my area.
The work published so far is only the starting point for a long line of research and unfortunately in molecular biology the picture almost always turns out to be way complex than originally thought. The more research that is done the more questions are raised and the more complicated the whole puzzle gets. The human body is just so complex that it's rarely anything is ever fully understood. There are probably multiple factors at work in PPCM.

[jaksmom03]

this is so weird that I came across this! my daughter is 9 months old and I have been having PVCs and SVT. Allie is my second child and started noticing my heart while pregnant but was told it was normal, never had this problem when pregnant with my first. I also had a uterine infection after allie which they think effected 2 of my valves, I am now suffering from a high heart rate and am headed to cleavland heart clinic of wed to see if they can help me. Doctors kept telling me it was anxiety I HATE THAT every time I would go in with a genuine health concern they would say are you sure your not just having some anxiety!!!! I swear I had had it...my doctor would not order any heart test and I had to beg to have anything done and sure enough there was somthing wrong and it was not anxiety. Doctors want to chuck up everything to depression and anxiety which does exist and can cuase problems but so many things are going untreated and its being used as a catch 22......pregnancy can take a tole on your body thats for sure with my daughter I found out I was pregnant and had gallstones same day...I was sick for 4 months only thing I put in my body was gatoraide and beef broth until they could safley take it out and I wouldnt lose the baby so pregnancy is also a very amazing thing aswell and totally worth it. I just wish doctors werent so quick to call it anxiety!!!! that really pisses me off! I swear I had a doc try to tell me I didnt have bronchitis ....IT WAS ANXIETY now that takes the cake!

[aussie mum]

Hi degrassi

Well i recovered without any form of meds !! My EF was only mildly down 45/50. I had many trips to my cardiologist for echo's ect so i was well looked after. I breast feed until my bubba was 14 months. However i recently just miscarried which left me with mild LV enlargement for which i will have a echo in 6 months to see how things are going. My cardio doc said he feel all will be fine :}

[degrassi]

great news..............the recovery rate for PPCM is 80%. :) :)  You have a lot more patience than I had..breast feeding for 14 months...........my little sucks got nasty when their teeth came in, and they got weaned very quuickly.

[dolfnlvr]

I thought I was crazy.  The docs said that pregnancy had nothing to do with the PVC's, but I started having them about 1 month after weaning my first born.  Just so happened it was near the same time as the 9/11 attacks and I was told I was having anxiety issues (until they actually heard them with the stethoscope and said "wow, that's not normal").  Then, I got pregnant again, and had almost NO symptoms through pregnancy and nursing them BOOM two months after weaning her I had HORRIBLE bouts of PVC's.  Now they come and go, and started mixing with SVT which scares the begeeses out of me.

I'm not planning to get pregnant again to test my theory, but I've always told my docs that it had something to do with it.  Wish I knew what.

[finetilthree]

Yep, same thing happened to me, hence my screenname.  I'd love to see the docs response if this question were posted on their forum.  

[dolfnlvr]

I have to say I'd like to hear it too.  Though I'm convinced that they would say the same thing they all say.  "You won't die from PVC's and while it is very uncomfortable while it is happening, the best thing to do is relax and wait it out."  As for the pregnancy link, I don't think anyone has done the research.

I wish I could find someone who was willing to do the research.  I'd probably sign up.  I always tell my doc, I'm the healthiest sick person on the earth.  The worst part is how they keep trying to convince me that it's all in my head.  Thanks you guys....it can't be in all of your heads too.

[degrassi]

there is a difference between pvcs and PPCM.

[finetilthree]

yeah, we all realize that.  

[deedle1976]

There is research which shows that PVCs and VT are induced by pregnancy, however there is no information regarding the actual cause of this. I think it would be difficult to determine experimentally. It's a while since I read the papers but if I remember correctly the authors suggest that the arrhythmogenic effect of pregnancy is due to hormones (they don't specify which ones), increased sympathetic tone, haemodynamic strain and the increased stroke volume of the heart (required to pump all the extra blood around).

There are two papers in the medical literature I have read. The first one is
"Characteristics of new-onset ventricular arrhythmias in pregnancy" published in the journal of electrocardiology.J Electrocardiol. 2004 Jan;37(1):47-53.

People on this thread will agree with the very first line of this paper which says
"The characteristics and underlying mechanisms of new-onset ventricular arrhythmia during pregnancy have not been adequately investigated".

The other one from the american journal of cardiology is
"Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness, and syncope".Am J Cardiol. 1997 Apr 15;79(8):1061-4.

There is another one  called "New-onset ventricular tachycardia during pregnancy."  Am Heart J. 1992 Apr;123(4 Pt 1):933-41.
I haven't read this one though, just the abstract.

[deedle1976]

I was admitted during pregnancy to the hospital that I worked in at the time, which happens to be a tertiary referral center for PPCM. I was having an echo and was chatting away to the tech. She said to me that she had gone off the idea of ever getting pregnant after seeing what pregnancy can do to the heart. I thought that was a bit of an extreme comment to make (especially to a patient!) but I guess she must see alot of bad cases.

[aussie mum]

Hi just wondering how your PPCM is now ?? Did you have it whilst pregnet ??

[deedle1976]

I didn't have PPCM. I was admitted to hospital because of very frequent PVCs and nsvt and syncope. They weren't TOO worried about that but I had several ECG suggestive of left ventricular hypertrophy so they just wanted to rule out PPCM. The syncope was due to anemia.

[nikgirl28]

they also say there is an increase in getting POTS after pregnancy...which is a form of SVT because it is above the ventricles...so when u get pregnant your heart has to deal with the extra blood volume...and then after you deliever the baby your blood volume decreases...different for every women....so you do get svt because your heart is trying to deal with the lack of blood is has to pump and it goes into like a crazy hurry up and fill me up mode...so eating a big meal you are taking more blood away from the heart and giving it to your digestive system giving u svt...and pots in when u stand up quickly and your heart goes crazy filling up with blood because it doesn't have all that blood during pregnancy...pacs seem to me more related to problems with my digestive system...and pvcs seem to be more related to hormones...and svt..pots...ist...a-fib...seem to be more related to lack of blood volume...
just what i think

[deedle1976]

I have a friend who had one PVC for every two normal beats for most of her pregnancy. So thats about 33,000 PVCs per day. She spent the whole pregnancy feeling awful and like she was going to drop dead. Now post pregnancy she is having fewer PVCs but still several per minute, every minute. The thing is now she can't feel them at all so she's not one bit worried about them anymore, even though she knows she's still having thousands. It was really the sensation of them that had been making her so anxious, not the knowledge that she had them.

[deedle1976]

I didn't know that about pots. That is interesting.

[dolfnlvr]

Wow.  Thanks for the medical paper info.  I find that fascinating.  It's funny though.  I know that no doctor can cure me of this, and I get that I won't die, but it's an issue for me, and I find it difficult to "let it lie."  There's that bit of unfairness, like, okay, I had a higher blood volume during pregnancy, and maybe my heart needed to readjust afterward, but gee it's been 3 years since my last child, it'd be okay with me if everything evened out already!!!!

Thanks everyone, this has been an interesting thread!

[aussie mum]

This has been a VERY interesting forum !! It has made me wonder a lot about what happened and is still happening to me.  I go back for a follow-up echo in December so I'm going to throw some of these " theories  " at my cardiologist and get his view on them. It seems during ones pregnancy we are given information about so many things but never once was anything ever mentioned about my heart !!

Not that i can turn bad time for myself (LOL) but maybe if more research is done in relation to the theories discussed in this forum then things can be done pre pregnancy to prevent it from happening to other !!

:}

[deedle1976]

I never knew what a strain pregnancy was on the body. I don't know if I could put myself through it a second time knowing that now. My epilepsy came back after the birth after 9 years of being seizure-free and off meds. So now I'm back on meds, which make me braindead plus I can't drive for a year, which is v inconvenient when you've got a new baby to tote around. At least its not life threatening though.

[aussie mum]

Well i would love to have heaps more kids but just not be pregnet (LOL) Maybe these are the issues they should teach expecting mum's at there anti-natal classes not just how to change a nappy!!

I take my hat off to you (a aussie saying ) for having to deal with all you have to deal with :}

Hope all goes well for you in the future !!