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cardiac issues after birth

My niece, 28, gave birth 4 months ago. She was very healthy before and during pregnancy. The child was born in term and is healthy too. Three months after the birth, my niece developed cardiac issues, established by ECG. The doctors do not give any precise diagnosis. Is there an OB/GYN who will guide me on cardiac issues during and after pregnancy? Thanks in advance.
Poster
  • Female | 29 years old
  • Complaint duration: 90 days
  • Medications: antibiotics
  • Conditions: traumatic childbirth, heavy periods

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There is a rare condition called peripartum cardiomyopathy, and this is a possibility. If your niece was seen by a cardiologist they would most certainly have arrived at a diagnosis. Peripartum Cardiomyopathy is generally diagnosed by ECHOCARDIOGRAM so if she hasn't had that done , she probably should, and she will need to see a Cardiologist.
Kyle A Baker
Unfortunately it is difficult to give you much guidance because the diagnosis of "cardiac issues" is too vague. A board certified cardiologist should be able to give your niece a diagnosis and then she can take that information to a Maternal Fetal Medicine doctor also called a perinatologist (high risk OB) to get an opinion about future pregnancies. Good luck.
There are so many possibilities here. Some women get cardiomyopathy that sometimes resolves over time. There are heart valve disease conditions that need treatment. A qualified cardiologist can help evaluate and advise her.
To develop cardiac problem after delivery usually means that there was something with the heart from before such as presence of a murmur,history of strep throat years before. She needs to see a cardiologist not a gynecologist .
Victor Shabanah
Pregnancy-induced changes in the cardiovascular system develop primarily to meet the increased metabolic demands of the mother and fetus. Blood volume increases progressively from 6-8 weeks gestation and reaches a maximum at approximately 32-34 weeks with little change thereafter. Red cell mass is increased on 20-30%. Cardiac output increases to a similar degree as the blood volume.The heart is enlarged by both chamber dilation and hypertrophy. Upward displacement of the diaphragm by the enlarging uterus causes the heart to shift to the left and anterior. From mid-pregnancy, the enlarged uterus compresses both the inferior vena cava and the lower aorta when the patient lies supine (on the back). Obstruction of the inferior vena cava reduces venous return to the heart leading to a fall in cardiac output by as much as 24% towards term. After birth, the woman gives off nearly 10 kg weight (amniotic fluids, fetus, placenta) which decompresses the inferior vena cava. In addition, even an uneventful delivery is expected to give up to 500 ml blood loss. Such shifts are not supposed to cause cardiac problems in healthy women.

Some women, however, may develop so-called peripartum cardiomyopathy (during the last month of pregnancy and the first 5 months postpartum). Etiology remains unknown, with autoimmune, viral (coxsackie B, influenza), and genetic predisposition suggested.

Symptoms of peripartum cardiomyopathy are LEFT-sided failure and dilated hypocontractile ventricles. Common treatment includes bed rest, restriction of sodium and beverages, prescription of digitalis, and diuretics (with potassium supplementation). An anticoagulant may be necessary to prevent thrombi.