Coronary Heart Disease and Pregnancy

To all the ladies out there with heart issues... I am 38 and been told I have a 50% blockage of the LAD artery (awaiting angiogram for full confirmation) but I have been trying for a baby for the last 5 years but I am now worried if I don't have a stent fitted then my heart won't be strong enough to cope with pregnancy and child birth. Anyone had the same issues and what the outcome was?

[Milkfairy Heart Star]

Hello,

Welcome to the forum.

Have you spoken to the Cardiology team about your wish to try for a baby?

I suggest you discuss this issue before you have your angiogram.

It's important to get specialist advice about which medications you can safely take during pregnancy.

Larger maternity units have a specialist service to care for women with heart problems who are pregnant and they provide pre pregnancy counselling

Here is an example of such a service, you can ask your Cardiology team to get in contact with this centre for further advice too.

rbht.nhs.uk/our-services/he....

Good luck!

[Qualipop]

I think but am not certain that they don't stent until a blockage reaches 70%- at least hat's what hey told me when I Had two 65% blockages. IT depends more on how well blood flows past the blockage. I had an echo scan which showed mine were ok and didn't need stents. HOwever I'm years past childbearing age so you definitely need to tell the cardiologist your plans and get his/her advice.

[MarmiteB]

Hi Ally,

I hope that you are OK - I know all of this is a bit scary! Keep reading this long post, I just wanted to put all the detail I can for you!! I am happy for you message me privately if you want to chat more about the below My first piece of advice is that you must talk to your cardiologist so they can tailor your care to you. Must must! But, I am happy to tell you my story so far.

So, I am 34 and ended up having a double by pass in January as my LAD and right coronary artery were fully blocked. I have a healthy lifestyle, a normal BMI and eat well etc I was just unlucky with a previous illness that caused the damage. My plan was to start trying for kids after getting married (October last year) but when I was first talking to the cardiologist, a few weeks after my wedding, before we knew the extent of the damage, he asked me to use contraception and NOT GET PREGNANT (for now!).

At the time, he didn't want me falling pregnant because he didn't know the extent of the damage and at that point they needed me to not get pregnant due to the huge pressure it puts on your heart. Another big factor was the drugs he put me on.

Satins - which are contraindicated 3 months before and during pregnancy and breastfeeding due to statins potentially interferring with the embryo's development.

Betablockers - Women taking beta blockers may be more likely to have a small baby; however a small baby can be due to underlying health conditions that beta blockers are commonly used to treat, like high blood pressure.

Asprin - they are happy for you to stay on asprin when pregnant becasue hasn't been found to be harmful.

Since my op I have also been put on clopidogrel for a year which is a blood thinner and they don't like you on it whilst being pregnant because potential increased risk hemorrhage.

I had a meeting with my cardiologist, Dr B, 10 weeks post op and we discussed lots of things but one of them was having children. I told him that my two biggest worries were/are passing on any faulty genes to them or having them and dying in my 50s and leaving my husband widowed with teenagers.

Dr B is a kind man and assured me that having had surgery should not interfer with me having children and having a my unusual heart disease was not genetic and that it was very unlikely that I was going to die young. He said that what has happened to me should not be a factor in my decision to have children and that they could support me if I chose to have them. He was lovely, I'll admit I did tear up a bit!

So, I now have an appointment with a cardiologist who specilaises in women with heart disease who want to have children. My appointment is on Tuesday and I am happy to take any questions you have to her as I am sure that they could be helpful for me too. I am also happy to tell you what is said/done in the appointment if you would like to know.

To your worry... "If I don't have a stent fitted then my heart won't be strong enough to cope with pregnancy and child birth." My answer is that you must talk to your cardiologist as your heart has to work really really hard when you are pregnant. My caridologist, my Dr and my surgeon all said that. They liken it to your heart having to jog for 9 months rather than walk so they want it to be as supported as it can be, which in your case may include a stent. The stopper I can see is that they are likely to want to put you on clopidogrel (blood thinner) after your stent for 6-12months which as I said above, they don't like you to be on preganant. Having said that, my cardiologist wasn't that concerned about me coming off it as I was bruisung quite badly with it so there may be a few schools of thought on it.

So, take comfort that I have a huge heart operation and they are still happy for me to have kids, they will alter my medications accordingly and they are supporting me through it.

In regards to childbirth, Dr B has said that I would have a "normal" birth and depending on how my pregnancy goes, I may have to have the baby at a hospital with a 24 Cath lab in case they need to look at my heart but he seemed very relaxed about it. He also said that I would be unlikely to be offered a planned c-section as that could put more strain on my heart, I am not quite sure why!

I really hope that this helps! Good luck and make sure you speak to your cardiologist xx

[Milkfairy Heart Star in reply to MarmiteB]

Fantastic response!