Heart Health and Pregnancy Recommendations From Intermountain Health

For women with a heart condition or other high-risk health condition who are considering pregnancy, the maternal fetal medicine experts at Intermountain Health say it is important to identify risk factors for heart disease and get those risks treated before pregnancy or very early in pregnancy.

“More than 40% of reproductive age people who could become pregnant have at least one chronic medical condition or obstetric risk factor,” said Jennifer Merriman, MD, a maternal fetal medicine physician with Intermountain Health who specializes in high-risk pregnancy. “And some women may not know they have symptoms or risk factors such as high blood pressure or diabetes that make them more at risk for heart disease before they get pregnant, during pregnancy, or after childbirth.”

Some women may not recognize their symptoms until it is serious. Or they may know they have symptoms or health conditions, but haven’t talked to a doctor about it or aren’t being treated for it before becoming pregnant. These conditions and other factors can make them more at risk for developing a heart condition or complications during pregnancy.

“If a woman is thinking about getting pregnant and is older or has health conditions, it’s important to talk to a health provider before getting pregnant. If a woman is already pregnant, it’s important to see a health provider very early in the pregnancy, to get those risks identified, treated or monitored, as they could affect mom or baby,” said Dr. Merriman.

If heart conditions go unrecognized or untreated, women can be at risk for heart attack or death. Because women’s heart disease symptoms are different than men’s symptoms, their conditions may be under-recognized by women themselves and by health professionals.

Heart disease is the leading cause of death in the United States for both men and women. A recent study shows more women are more concerned about their risk of breast cancer than heart disease, and awareness of heart disease has gone down. Heart disease in women can be overlooked or missed, and as a result it can be undertreated.

There may be biases in healthcare, and also inequities in care, that contribute to under-recognition and undertreatment of heart conditions in women. There are health disparities and many social barriers that people face that prevent them from seeking care, like financial worries, lack of social support, poor understanding of health-related issues, or they are too busy with life.

Known risk factors for heart disease for both women and men

Dr. Merriman highlights these Conditions to Identify and Control:

• High blood pressure
• Diabetes
• Obesity
• High cholesterol

But she adds that simple lifestyle changes can reduce risk, including:

• Eating a healthy diet
• Not smoking or vaping
• Being active
• Geting about eight hours of sleep each night

For more tips, see https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8)

How women’s symptoms of heart disease differ from men’s symptoms

Many times, the symptoms of a heart attack in women is similar to men – crushing chest pain. But sometimes symptoms may be vague, such as shortness of breath, nausea or fatigue. As a result, women and care teams may miss heart disease and attribute symptoms to ‘anxiety’ or other conditions. Sometimes other symptoms may overshadow a woman’s complaint of chest pain.

In the United States, there are high rates of maternal mortality, meaning death around the time of childbirth. This is due to older age of mothers, having more health conditions that increase their risk of heart disease, and more complex heart conditions.

For more information about women and heart disease visit: https://intermountainhealthcare.org/services/womens-health/general-womens-health/preventative-care-guidelines/cardiovascular/

For women with a heart condition or other high-risk health condition who are considering pregnancy, the maternal fetal medicine department at Intermountain Medical Center has a Pregnancy Preparation, Prevention and Risk Evaluation (PrePPARE) Clinic which offers pre-pregnancy risk assessments and evaluations. Call 801-507-7400 for more information, or see https://intermountainnv.org/womens-health-services/obstetrical-care/.

Jennifer Merriman, MD, is a praciting maternal fetal medicine physician with Intermountain Medical Group who specializes in high-risk pregnancy.

About Intermountain Health

Headquartered in Utah with locations in seven states and additional operations across the western U.S., www.intermountainhealth.org is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.