Cardiovascular disease during pregnancy can pose unique challenges. Increased blood volume and heart rate, along with other changes that occur during pregnancy, can put additional strain on the heart, which can complicate pre-existing conditions and introduce new cardiovascular issues.
At Brigham and Women’s Hospital (BWH), we provide highly specialized care for women with cardiovascular disease before, during, and after pregnancy as part of the Cardiovascular Disease and Pregnancy Program. Our multidisciplinary team of experts, including maternal-fetal medicine (high-risk pregnancy) specialists, cardiologists, interventional cardiologists, cardiac surgeons, and specialized nurses, is dedicated to delivering the highest level of care for both the mother and her baby.
Pre-existing cardiovascular conditions may include:
Cardiovascular conditions that arise during pregnancy may include:
Women with pre-existing cardiovascular conditions who are planning a pregnancy and women who develop cardiovascular issues during pregnancy require specialized care. In these cases, it is important that a team of specialists in many disciplines – including maternal-fetal medicine (experts in high-risk pregnancy), cardiology, interventional cardiology, and cardiac surgery – be closely involved in the care of both the mother and the baby.
Whenever possible, planning with the medical team should begin before conception for women with pre-existing cardiovascular conditions in order to best understand the risks of pregnancy and how to manage conditions safely during pregnancy. Improvement in fitness level, adjustments in medication, and other recommendations may also be made prior to conception to prepare for the changes that occur during pregnancy.
A detailed prenatal care plan is developed to address the mother’s individual health issues. A comprehensive assessment of conditions and symptoms should be performed, including advanced cardiovascular imaging techniques that are safe for use during pregnancy. Ideally, medication adjustments and planning are started before or early in the pregnancy.
Katherine E. Economy, MD, MPH, collaborated with Neal K. Lakdawala, MD, from the Center for Advanced Heart Disease, to develop a treatment plan for a patient with endomyocardial fibrosis, a rare heart condition.
A delivery plan should include specific scenarios that may present during delivery. In addition to the prenatal care team, cardiac and obstetric anesthesiologists are a key part of this process. Postpartum care should be coordinated with the care providers for the mother and baby after delivery and discharge from the hospital.
The Cardiovascular Disease and Pregnancy Program at Brigham and Women’s Hospital (BWH) offers expert care for women facing a wide range of cardiovascular complications before, during, and after pregnancy. These include cardiomyopathy, structural heart disease, coronary artery disease, vascular disease, arrhythmia, and other serious cardiovascular conditions.
Experts from maternal-fetal medicine, cardiology, interventional cardiology, cardiac surgery, adult congenital heart disease, vascular medicine, electrophysiology, prenatal genetics, infertility, reproductive surgery, and other specialties collaborate to ensure that women are carefully evaluated and treated to address health needs of the mother and the baby. These specialists also work closely with the Congenital Heart Failure and Adult Congenital Heart Disease Program, a program jointly offered by BWH and Children’s Hospital Boston for young adult patients with congenital heart disease. Patients who are followed by the Program are provided with seamless care during pregnancy by specialists in the Cardiovascular Disease and Pregnancy Program.
To schedule an appointment or to learn more about our services, please contact us at (617) 732-4840.
Brigham and Women’s Hospital
75 Francis Street
Boston, MA 02115
Katherine E. Economy, MD, MPH
Division of Maternal-Fetal Medicine
Anne Marie Valente, MD
Division of Cardiovascular Medicine
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