Coronary heart disease and pregnancy
Coronary heart disease (CHD) is when your arteries get narrower due to a build-up of fatty deposits inside them. This restricts the flow of blood and can lead to chest pain, called angina, or a heart attack.
Your heart needs to work harder in pregnancy so, if you've got heart disease, it's important to get the right care and support.
Some women develop heart problems for the first time in pregnancy.
Non-urgent advice: Call your midwife or GP if you have:
- chest pain or breathlessness when you're lying down
This could be a sign of heart disease and needs to be checked.
You can call your maternity unit if you cannot get in touch with your midwife.
Immediate action required: Call 999 if you have:
- chest pain that spreads to your left arm, neck or back
This could be a sign of a heart attack.
Planning on getting pregnant
If you have heart disease, the best way to ensure a healthy pregnancy is to visit your GP or heart specialist (cardiologist) before you start trying for a baby. This is called pre-pregnancy counselling or pre-conception counselling.
Your specialist can discuss with you:
- how your heart condition might affect your pregnancy
- how pregnancy might affect your heart condition
- your medicine – including a plan for stopping your medicine or switching to a different one to minimise the risks to you and your baby
If it is not possible to stop taking certain medicines, your doctor can discuss the chances of any problems associated with this treatment during your pregnancy.
Do not stop taking any medicines without consulting your doctor or cardiologist first.
If you're taking aspirin for your condition, it's safe to continue during pregnancy.
If you have had a stent inserted to stop your arteries from becoming narrowed or blocked, you'll need to discuss with your cardiologist:
- how pregnancy may affect the stent
- the best way of managing the stent in pregnancy to make sure it does not become blocked
Getting ready for pregnancy
You can prepare for pregnancy by:
- losing weight, if you're overweight
- not smoking
- keeping your blood pressure well controlled
Find out more about coronary heart disease.
What are the problems of CHD in pregnancy?
The main risk for women with CHD is that they'll have a heart attack during pregnancy. Cardiac disease is rare in pregnancy, but it is a leading cause of women dying in pregnancy.
The chances of any harm to your baby are unknown, although some of the medicines you may be taking for your CHD or related conditions, such as diabetes or high blood pressure, may affect your baby.
Women who have a higher chance of developing CHD are those who:
- are overweight
- have a family history of early CHD – if your father or brother was diagnosed with CHD before the age of 55, or your mother or sister was diagnosed before the age of 65
- have diabetes
- have high blood pressure
- are older – the older you are, the more likely you are to develop heart disease
The more of these things you have, the more likely it is you'll develop heart disease.
Your care in pregnancy
During your pregnancy, you should be under the care of a consultant obstetrician and a cardiologist in a hospital maternity unit.
You can expect to have more frequent antenatal check-ups, particularly if your CHD is related to other conditions, such as diabetes or high blood pressure.
Make sure you attend all your appointments or reschedule them if you have to cancel.
While you're pregnant you should:
- eat a balanced diet – find out more about a healthy diet in pregnancy and foods to avoid in pregnancy
- control your weight
- exercise – but speak to your midwife or GP before taking up any new exercise
- stop smoking
Labour and birth
Discuss your options for where you can give birth with your healthcare team. This should include a heart specialist with experience in supporting pregnant women with heart disease.
You may be advised to give birth in hospital.
Page last reviewed: 10 April 2018
Next review due: 10 April 2021