Last year, when Shana Melanson was four months pregnant with her second child, she was standing outside a light rail station waiting for the shuttle she takes to work when, suddenly, she fainted. She fell on the concrete and broke her nose.
Shana spent the next five days at University of Washington Medical Center while her cardiology and maternity care team adjusted her medications and made sure she—and her baby—would be OK.
This wasn’t the first time during her pregnancy that Shana’s heart had caused her to lose consciousness. Three months earlier, it happened at a conference in Canada.
“I was eating lunch having a conversation with another attendee and I just passed out and fell on the floor,” she recalls.
Shana, 38, has a heart condition that causes her heart to lose its normal rhythm and stop pumping blood—a form of cardiac arrest—that her doctors believe is triggered by pregnancy.
Her heart troubles started when she went into sudden cardiac arrest three months after giving birth to her first child. That was three years ago, and until the conference room episode, she had never had symptoms.
Pregnancy with heart disease can be complicated
Heart disease in pregnancy can come in many forms: It ranges from women who were born with a structural heart problem, such as a faulty heart valve, to women who have underlying health problems and have developed heart disease as a result, says Catherine Albright, M.D, M.S., an obstetrician at the Maternal and Infant Care Clinic at UW Medical Center who cared for Shana.
And while concerns with pregnancy can vary based on the nature of her heart problem, the things providers are concerned about are often the same.
During the course of pregnancy, the amount of blood in circulation increases by about 50 percent, greatly increasing the amount of work the heart must do, Albright explains. That, combined with other changes in the body and the physical work of carrying a child, puts a lot of demand on a mother’s body.