Regular Heart Sisters readers might have already picked up the same red flag that I did when reading Elissa’s story. For example, she wrote, “. . . high blood pressure left over from a recent hypertensive pregnancy.”
When I asked Elissa about her hypertensive pregnancy, this story suddenly became even more intriguing after she replied:
“I was diagnosed with HELLP syndrome when I was pregnant with my first child, who was born just shy of 36 weeks. My next two pregnancies were induced at 39 and 38 weeks respectively because of my high blood pressure.”
According to the Preeclampsia Foundation, Elissa’s condition called HELLP syndrome (Hemolysis. Elevated Liver enzymes. Low Platelet count) is a life-threatening pregnancy complication that’s considered to be a variant of preeclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth. The global mortality rate of HELLP syndrome has been reported to be as high as 25%. Elissa added:
“When this whole chest pain thing started, I already knew about and mentioned to my primary doc the relationship between preeclampsia and future cardiac issues. I was very surprised when he resounded with ‘I’ve never heard of that.’ My pregnancy history was summarily dismissed by every single healthcare provider I saw as an unimportant detail.”
Consider carefully Elissa’s last statement: every physician she saw about her cardiac symptoms dismissed her history of pregnancy complications as an “unimportant detail.”
But by now, we know that pregnancy has been called the “ultimate cardiac stress test”. We know that pregnancy complications can more than double a woman’s risk of developing future heart disease. We also know that other pregnancy complications like preeclampsia (as I experienced during my first pregnancy), gestational diabetes, placental abruption, and having a preterm or a full term/low birth weight baby are all associated with higher cardiovascular disease risk. See also: Pregnancy Complications Strongly Linked to Heart Disease.
When the American Heart Association officially added pregnancy complications to its list of cardiovascular disease prevention guidelines in 2014, they wrote:
“Essentially, having pregnancy complications can now be considered equivalent to having failed a stress test.”
I was invited to speak at a 2014 Toronto medical conference on preeclampsia, where I had the opportunity to hear another speaker, Dr. Eric Steegers, a researcher from the Netherlands. He described pregnancy complications as “a short-term problem for the OB-GYN, but a longterm problem for the cardiologist”.
But because most women with the pregnancy complications listed above have rarely been considered at high risk for cardiovascular disease, he warned that current cardiac treatment guidelines are not tailored to this group of young women.
Elissa turned out to be a success story, but it took her own sleuthing to arrive at an appropriate diagnosis and treatment. As I now tell my readers and my women’s heart health presentation audiences, we really do have to become our own best heart health advocates.
And as I told Elissa:
“Your only job now is to become the world expert in your diagnosis.”
And by the way, I’d like to have a wee chat with the physician who advised Elissa that all she needed to do was to “take a few weeks off from parenting.” I think I’m going to go embroider that advice on a pillow . . .
Elissa’s photo credit: Jillian Butler Photography
(1) Camm AJ; Cardiac Arrhythmias–Trials and Tribulations. Lancet. 2012 Oct 27;380(9852):1448-51.
PLEASE NOTE: I am not a physician so cannot advise you specifically on any symptoms you may be currently experiencing. If you’re having cardiac symptoms that feel unusual for you, do not leave a comment here listing them for me. Instead, consult your physician.
Q: Have you experienced a cardiac diagnosis that was ultimately linked to a pregnancy complication?
NOTE FROM CAROLYN: I wrote much more about how pregnancy complications increase our risk for developing heart disease in my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (and use the code HTWN to save 20% off the list price).
Heart Palpitations: A Serious Problem or No Big Deal?
Pregnancy Complications Strongly Linked to Heart Disease
What Women Need to Know about Pregnancy Complications and Heart Disease
Pregnancy: the Ultimate Cardiac Stress Test