Matters of the heart...

I’m no love doctor but I am qualified to save your life in the event of a heart attack.

With that being said, I thought it was time I discussed a topic that is close to my heart…the most important organ in our bodies…the heart!

I am known to ramble on about this topic for obvious reasons but I promise I will keep it to relevant content here!!! For this reason, I have made this section a two part series; the first part addressing chest pain and the second part addressing palpitations.

One of the most common symptoms I am asked about is chest pain. Chest pain can affect any age and in my clinic, it is my duty to determine if the chest pain is cardiac in origin.

Omitting causes of chest pain in the general public, I wanted to concentrate on what causes chest pain while pregnant and post birth.

Pulmonary Embolism – a clot in the lung

Pregnant women and equally, women who have just given birth, have an increased risk of developing a deep vein thrombosis. This is because, during this period, the clotting factors within our blood are more likely to thicken and form blood clots. There is slower blood flow around our pelvic region as an expanding uterus constricts our blood vessels and pelvic circulation, leading to clot formation within the deep veins of our legs. If however, one of these clots happens to dislodge, it may travel within the bloodstream into our lungs and cause a blockage in one of our arteries supplying the lungs. The resulting symptom is chest pain. It is most commonly described as chest pain worse on inspiration (when breathing in), accompanied with shortness of breath. Some may also experience coughing up blood-stained sputum.

A more severe case would present with blackouts, extreme shortness of breath, blue lips and palpitations. This is an emergency.

If you notice asymmetrical swelling of one of your calves with some mild ache on walking, I would suggest you visit your GP for an examination. If you are found to have a deep vein thrombosis or a pulmonary embolism, you will be treated with blood thinning injections.

Characteristics of chest pain – As mentioned before, this pain can be located anywhere within the chest and is typically described as worse on inspiration. There may be accompanying shortness of breath or blood-stained sputum. Some ladies may have noticed asymmetrical calf swelling prior to experiencing the chest pain.

Musculoskeletal – muscular ache

As our ribcages are being put under pressure trying to expand during pregnancy, it is inevitable that the musculature in that area may start to feel tender. This can also occur especially if the baby’s feet are located towards your ribcage and baby kicks often. Women are more likely to experience this in pregnancy rather than in the postpartum period.

Musculoskeletal pain is often tender to touch in certain areas, worse in certain positions and better in others.

Most ladies, bear with it while their baby moves around and changes position from time to time, but others cannot achieve any amount of comfort without taking pain-killers such as paracetamol. This is fine too.

Characteristics of chest pain – The pain can be located anywhere in the chest. It is typically a specific region which is tender to touch. Some positions such as lying down may ease the pain a little while other positions may worsen it.

Oesophagitis/Gastro-oesophageal reflux - heartburn

This symptom is another one which is more common while pregnant rather than during the postpartum period. As baby grows and the body starts to expand, many of our usual bodily processes slow down. Several ladies become constipated as their process of digestion slows down. Muscles become weaker, such as the sphincters that control passing urine and this often leads to leakage of urine at times of increased pressure such as coughing or sneezing.

Similarly, the sphincter that controls food passing from the oesophagus (food pipe) to the stomach weakens in pregnancy resulting in food coming back up the food pipe. This is felt as heartburn or oesophagitis. Some notice this symptom with particular foods such as spicy or fried foods, citrus foods, chocolate, or fizzy drinks. It is quite an uncomfortable feeling and I suffered with this with both of my pregnancies. I would find I could never eat much in one go but would have to eat small portions frequently in order to be able to eat enough throughout the day. Fried foods were a particular trigger of the heartburn.

Characteristics of chest pain - The pain is usually central in location and feels like a burning rising up your chest to your neck. It can be associated with acid being regurgitated into your mouth causing you to taste acid at the back of your throat.

If it becomes unbearable, some ladies opt to take Gaviscon, Ranitidine or Omeprazole to help combat the reflux of acid. The last two medications require a prescription so please go and see your doctor if you are suffering.

As soon as baby arrives, you will be surprised how quickly this symptom resolves…it’s a shame I can’t say the same for the pelvic floor muscles!!!

Myocardial Infarction – heart attack

The dreaded heart attack…thankfully I haven’t seen many pregnant or postnatal ladies having heart attacks. It is far less common than the other conditions I have mentioned. You will be happy to know that pregnancy does not increase your chances of having a heart attack.

Characteristics of chest pain - This chest pain is described as a squeezing or constricting pain in your chest (usually central). Some people commonly say that it feels like ‘someone is sitting on your chest’. It can radiate to your left arm, neck or jaw and can be associated with nausea, sweats or shortness of breath. The person who is having a heart attack looks pale and sometimes even grey. They do not look well at all!

Risk factors for heart disease include:- smoking, high blood pressure, high cholesterol, diabetes, previous heart attacks, and a family history of heart attacks.

The treatment is…GET TO YOUR NEAREST HOSPITAL AS SOON AS POSSIBLE! You may need an angiogram (a mini operation to look into your heart) and a stent placed into your artery.

If you wanted to meet me, there are other ways to do so, I truly do not wish to meet any of you this way so stay healthy and ensure you target/eliminate the above risk factors as best as you can.

So ladies, I hope you have a little more clarity on chest pain and are able to use the information on this post to guide you.

As always, nothing is better than seeing a doctor and getting examined if you have any of these symptoms.

I wish you all a healthy pregnancy and an even healthier journey through motherhood.

Speak soon

MCD

xxx

PS If any of you would like me to cover congenital heart disease (babies born with heart problems) then please message me.