low ejection fraction / pregnancy

[motherofsix]

I am a mother of six children. The youngest is over 18 months old. In January I was diagnosed with a low ejection fraction (30%). In May the echocardiogram showed an improvement (45%). I was told that was close to normal and I never  took  any medications. I understood that a pregnancy would be very risky with 30%, but how about 45%? Could the low ejection fraction even be the result of my last pregancy? I understood if there was an improvement with post partum cardiomyopathy it would happen within the first 6 months after giving birth. My ejection fraction improved when the babay was already almost 18 months old. Maybe an infection was the cause of the low ejection fraction......I never had any signs of heart failure  (I found out about the low ejection fraction because  of PVC's, which also have improved a lot). My blood pressure is on the lower side. Do we still have to do everything we can to avoid another pregancy?

[Pencl]

I was recently diagnosed with possible PPCM a year and a half after having my baby boy. My husband and I were planning to have another and start trying this summer. We wanted three but now, I'm just praying to God I will be able to have a second. My Mother died before my son was born when I was 31 and have wanted a little girl to name after her. This diagnosis is extremely hard to stomach and is a huge loss, and I feel I've had enough loss in my life already so young (brother too) . I would like to ask everyone reading this to pray for me. My EF is currently 50 but I've been told not to get pregnant. However, we are going to see specialists at the Mayo Clinic for a second opinion. I can't imagine having just one child and never experiencing a newborn or pregnancy again or my son not having a sibling. I know we all should be thankful for what we have and our health and there are so many other people out there who have lost their lives, kids lost their mothers and I try to focus on this and feel guilty at times for thinking selfishly but it's hard.

[enisa1981]

did you end up having another child? and did things get better for you health wise?

[anacyde]

I share your feelings on wanting to be open to the possibility, though my cardiologist has said no and I've slowly made peace with it (most days).  After facing infertility and pregnancy loss before finally having a healthy baby girl - then a healthy baby boy two years later - then I developed PPCM!  Everyone tells me be thankful for having one of each, etc etc., and I am, very much so.  It's just a difficult pill to swallow.  What other women can do without thought has always been conflicted for me, and my "ability" to have children has once again been taken from me.  Still, I recovered fully and when I look at my beautiful children I have to remind myself that there are two more than I was ever guaranteed :)

[motherofsix]

It's not like having six is like having sextuplets.......I don't know how they do it.........but we spaced them and personally I think it is much easier now that some older kids are around than when we had just three little ones. My dream was 8 kids, but now I would be more than happy with 7, LOL. Don't get me wrong, I am very thankful for our 6 healthy blessings and since I just turned 40 and with the heart worries chances that we will have  another one are slim. It is not so much about trying hard to have another one, but about the fear of getting pregnant while using NFP, which we would like to keep doing . I was very comfortable with it when we just wanted space between the kids but a life or death situation is much different. In general I would just like to stay open for the possibility of new life, without pushing for another pregancy. Our kids love to grow up in a large family and sometimes it seems like they are more into having another baby around than me......LOL.

[enisa1981]

i know this is old posts, but i wonder what have happened because i am going through similar situation. did you end up having another child? did your EF ever improved ?  

[specialmom]

Hi enrisa1981.  I would love to work on your own personal situation. Can you start a thread and tell us more?

[finetilthree]

What... are ya tryin to single handedly repopulate the world or something?  Just teasin'!! My youngest is 14 months old now, and everytime I see a newbie I get those familiar twinges all over again!! I'd have a dozen if my heart could handle it!! However, I must be satisfied with the three blessings that I was given.  Good luck to  you!

[motherofsix]

A mother's heart is a wonderful site. Thank you for letting me know about it. Unless my EF is over 50% I will not consider another pregnancy. If it gets better I will talk to the cardiologist and see what he recommends.
Thanks again!

[anacyde]

Because your heart function is not fully recovered, and if you did have a viral, autoimmune or pegnancy-related cardiomyopathy (you clearly had one of them) the beta blockers will help in multiple ways.  The answers to your questions are at A Mother's Heart :)  

I was asymptomatic at diagnosis except for palpitations, and my EF was higher than yours.  Since you lack the info about your heart following pregnancy (PPCM must be diagnosed in the first 5-6 postpartum months) then they can't say definitively, but it seems likely since your heart function has improved since the pregnancy.  Whether it was PPCM or an idiopathic cardiomyopathy, pregnancy would not be a good ideal unless you've regained 50% at least - or you'll almost assuredly lose function.  If it was indeed PPCM, there is a possibility that a subsequent pregnancy could land you in heart failure...and since you do not wish to take medications...it's best to avoid further pregnancy.

[motherofsix]

Hi and thanks for all your comments. No, I was not diagnosed with PPCM because of the lack of infomation about how my heart was doing after the pregnancy. I was never checked out for heart trouble until my last baby was already over a year old. There were never any symptoms of heart failure. I started taking my blood pressure since I felt dizzy a lot and it only picked up around 42 heart beats per minute and I contacted my family physician. Well, the dizzyness came from a sinus infection and ear infection and was gone after a couple of weeks. The low heart rate was a mistake of the cheap automatic monitor which did not pick up my PVC's. We decided to recheck the EF before I would take any medications. Since it improved I do not have to take the Beta Blockers. I was very reluctant to take them because of my severe multiple food allergies. I understand that Beta Blockers can turn a mild reaction to food into a severe lifethreatening one. I have mild reactions all the time. The risks often outweigh the benefits for me when it comes to medications. I will have another echocardiogram in November. The cardiologist was very please with the May results...........I guess I should wait until November. It's just that I am wondering if the infections I had caused my first low EF. Well, I am definitely assymtomatic. We are right now cleaning up the basement and I keep running up and down the stairs with no problems. Why should I take medications with all the side effects if I feel fine?

[anacyde]

Sounds exactly like PPCM (peripartum cardiomyopathy).  I had a mild version of this.  Please search for A Mother's Heart.  There is information there regarding subsequent pregnancy following PPCM.  Pregnancy is NOT recommended unless your EF has reached at least 50%, which is considered "recovered".  A normal heart size is also preferable.  Close watching and the use of certain medications is also advised.  You should be on a beta blocker for at least a year post-diagnosis and probably and ACE-Inhibitor has well.  If you haven't been on this regimen, I'd be wondering why and would seek another opinion from a cardiologist that specializes in heart failure.  While you did not experience overt heart failure, PPCM is a form of heart failure even without severe symptoms.

[finetilthree]

I agree with surfgirl.  The low EF could definitely be associated with your last pregnancy.  Did your doctor diagnose you with PPCM?  From everything I have researched, another pregnancy is VERY risky following a PPCM, and a recurrence is very probable.  Personally, it is not a risk that I would even consider with six little ones depending on me.  Talk to your doctor.  Best wishes.