What to do if pregnant women have heart failure

If a pregnant woman suffers from heart failure, it will not only pose a threat to her own health, but also have a fatal impact on the fetus. Pregnant women with heart failure need to be sent to the hospital for treatment immediately. Common symptoms of heart failure in pregnant women include palpitations, chest tightness, shortness of breath, etc. Therefore, when suspected symptoms appear, you must seek medical attention and treatment in time, and do not delay treatment.

What are the symptoms of heart failure in pregnant women?

Early heart failure in pregnancy and heart failure are descriptions of the same pathological state manifested at different times. In pregnancy complicated by heart disease, the textbooks include the following descriptions: Early detection of heart failure and timely diagnosis are extremely important. If the following symptoms and signs appear, early heart failure should be considered: chest tightness, palpitations, and shortness of breath after slight activity; heart rate exceeding 110 beats per minute and breathing exceeding 20 times per minute when at rest; often sitting up to breathe at night due to chest tightness, or breathing fresh air through the window; a small amount of persistent moist rales at the base of the lungs that do not disappear after coughing.

During pregnancy, the metabolic function of the pregnant woman's body is vigorous and the total blood circulation increases by more than 30%. The enlarged uterus during pregnancy forces the diaphragm to rise and causes the heart to shift to the upper left, affecting blood flow back and thus increasing the burden on the heart.

Heart failure, also known as "myocardial failure", refers to the inability of the heart to pump out a blood supply commensurate with venous return and body tissue metabolism. Various diseases often cause the myocardial contractility to weaken, thereby reducing the heart's blood output, which is insufficient to meet the body's needs, and thus produces a series of symptoms and signs.

Prenatal examinations should be carried out as soon as pregnancy begins. The number and intervals of examinations should be determined by the doctor. Pay attention to rest during pregnancy, avoid overwork, prevent emotional excitement, sleep at least 10 hours a day, and rest for at least half an hour at noon. Strictly limit salt intake to no more than 4 to 5 grams a day.

What are the causes of heart failure in pregnant women?

During pregnancy, the total blood volume increases by about 30-40%, reaching its peak at 32-34 weeks of pregnancy, when the heart is also under the greatest burden.

The increase in cardiac burden is even more obvious during delivery: with each uterine contraction, about 300-500 ml of blood enters the central circulation from the uterine wall. In the second stage of labor, in addition to uterine contractions, the abdominal and skeletal muscles also contract. Coupled with the forceful exhalation of air during delivery, the pulmonary circulation pressure and abdominal pressure increase, and the heart is under the heaviest burden at this time. In the third stage of labor, placental circulation stops. It can easily cause heart failure; on the other hand, due to the sudden drop in intra-abdominal pressure, a large amount of blood stagnates in the visceral vascular bed, and the blood returning to the heart is severely reduced, causing peripheral circulatory failure.

Within 1 to 3 days after delivery, the water retained in the tissues enters the blood circulation, causing another brief increase in systemic blood volume and increasing the heart load. Due to the above reasons, pregnant women with heart disease have the heaviest heart load at 32 weeks of pregnancy, during delivery and within 3 days after delivery, and are prone to heart failure. Heart failure should be promptly observed and treated in the hospital. In severe cases, the pregnancy should be terminated.

Controlling physical activity, avoiding mental stimulation, and reducing the load on the heart are beneficial to the recovery of new functions. However, long-term bed rest is prone to venous thrombosis and pulmonary embolism. It also reduces digestive function and causes cardiac atrophy. Therefore, patients with heart failure should be encouraged to take the initiative to exercise. Depending on the condition, start by sitting by the bed and gradually increase symptom-limiting aerobic exercise, such as walking.