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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.

You can develop heart problems for the first time during your pregnancy.

Non-urgent advice: Call your midwife, a GP or 111 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:

a sudden chest pain that:

  • spreads to your arms, back, neck or jaw
  • makes your chest feel tight or heavy
  • also started with shortness of breath, sweating and feeling or being sick

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 – this may include 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.

Aspirin

If you're taking low-dose aspirin for your condition, it's safe to continue during pregnancy.

Stent

If you have had a stent (a tiny tube used to widen a blood vessel) 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 so it works properly

Getting ready for pregnancy

You can prepare for pregnancy by:

  • losing weight, if you're overweight
  • not smoking
  • exercising regularly

Find out more about coronary heart disease.

What are the problems of CHD in pregnancy?

The main risk if you are pregnant and you have CHD is having a heart attack. Cardiac disease is rare in pregnancy, but it is a leading cause of death 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.

You have a higher chance of developing CHD if you;

  • smoke
  • 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:

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 treating heart disease during pregnancy.

You may be advised to give birth in hospital.

Find out more about labour signs and pain relief.

Page last reviewed: 29 April 2021
Next review due: 29 April 2024