Dr.Amar Singhal

Cardiologist

M.D.,D.M,F.A.C.C.,F.R.C.P(Glasg),M.N.A.M.S.
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HEALTH DETAILS

The findings in the recent survey "Visualising the Extent of Heart Disease in Indian Women" are worrisome. According to it, there has been an increase in cardiovascular diseases by 10-15 per cent among women in the age group 20-40 years. Since most of these women can bear children, special care is needed to ensure that they have a sound and healthy pregnancy. It is a common belief that if a woman is affected with a heart ailment, she should refrain from having a baby. However, the truth is that women with cardiovascular diseases can have a safe pregnancy if managed well. During pregnancy, the heart pumps 40 per cent more blood to the organs, thereby making it work harder which tends to put a strain on it. Also, to accommodate the increased blood flow, the blood vessels dilate thus, lowering the blood pressure. While a normal heart can bear all of this with ease, it becomes a little strenuous for a heart patient. But this in no way points to the fact that these women cannot experience the joys of motherhood. To begin with, heart patients thinking of conceiving should visit a gynaecologist for counselling so that they become aware of the risks that might be involved in their pregnancy. Depending on the family and medical history of the patient, she would be assessed and accordingly be prescribed a regime, which will be followed throughout those nine months. Also, a cardiologist needs to be consulted who will evaluate the patient’s heart condition and recommend any changes in the treatment that may be required before pregnancy. For routine check-ups during the gestation period, a visit to the cardiologist should be made as regularly as to the gynaecologist. Further, Electrocardiogram (ECG) and Echocardiography tests need to be conducted from time to time so that timely medication can be given in case any complications arise. Keeping a check on what the would-be-mother is eating is also important to ensure that the mother and baby are fit and fine. A heart healthy diet consisting of whole grains, green vegetables and fresh fruits and food containing high amounts of salt, fats and carbohydrates should be avoided. Monitoring one’s weight regularly and putting on the right amount of weight helps in the baby’s all round growth. However, one needs to be cautious so to not gain too much weight as this would create an additional pressure on the heart. Moreover, certain medications that a heart patient takes might be harmful for the baby. So, the medicine and its dose should not be adjusted unless a doctor is consulted. Besides this, the mother should try to be as stress free as possible to ensure her overall well-being. This can be done by taking adequate rest and avoiding strenuous physical activities. Being aware of one’s progress and asking questions about labour and delivery will also help in lowering anxiety levels. Smoking, consumption of alcohol or drugs is a big no-no during this period. However, there are some heart ailments, like problems with the mitral valve or aortic valve, which can be life-threatening for both the mother and the baby. Some of these might require something as major as heart surgery to be able to conceive without any future complications. In case a woman is suffering from pulmonary hypertension – a type of high blood pressure that affects the arteries in the lungs and the right side of the heart - or a rare congenital condition like Eisenmenger's syndrome, wherein there is backward flow of blood to the lungs, she should avoid pregnancy. The silver lining is that these serious heart problems only constitute a small segment. There are a host of common heart disorders like heart murmur (extra sound heard during a heartbeat), arrhythmia (irregular heart beat) and high blood pressure among others, which do not put any constraint on one’s pregnancy. One just needs timely consultations, proper guidance and a positive attitude to have a healthy and safe pregnancy. This article has been written by Dr. Amar Singhal, Head of Department, Cardiology, Delhi based Sri Balaji Action Medical Institute.

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