Introduction
Cardio-obstetrics is an emerging collaborative multidisciplinary field in medical sciences that focuses on the cardiac condition of a pregnant patient. Pregnancy is a natural stress that results in multiple physiological and mental changes within the human body like never before. During pregnancy, the escalating demands and necessities of the developing fetus, in addition to the mother's bodily tissues, throw an added burden on the mother's cardiovascular functioning. The heart's exertion is measured by the amount of blood it expels every minute, called the heart's cardiac output. It is essential to appreciate that even in regular patients and routine pregnancies, the heart and the entire cardiovascular system can be subjected to dramatic physiological changes. These changes include an apparent elevation in plasma volume by 50 percent, an increase in resting pulse by approximately 17 percent, and a noticeable rise in cardiac output by 50 percent.
How Is Heart Positioned During Pregnancy?
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The heart is shifted to a greater or lesser degree during pregnancy. This slight alteration is because the uterus becomes considerably larger, pushing the diaphragm toward a higher position. As a result of such physical movements, the heart budges slightly upward, to some degree to the left and a bit forward, leaving it just underneath, covered by the breast and closed by the chest wall. This displacement can lead to sensations of breathlessness or heartburn, especially in the later stages of pregnancy.
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Nearing the end of pregnancy, one's uterus increases in size to the dimensions that it lifts the heart at a right angle with the body’s long axis. However, such a lift is not the same for all pregnant cases. Such rotations and changes go up and down in different pregnancies.
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It is important to remember that despite the abovementioned factors, a perfectly healthy heart only increases in size marginally or not at all, even during the middle of pregnancy.
What Sounds Does the Heart Produce During Pregnancy?
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Cardiovascular Murmurs: All changes that occur during pregnancy result in cardiovascular murmurs. These murmurs are distorted sounds caused by functional and practical alterations within the heart. These distorted sounds do not signal any underlying malformations or unsettling disruptions but are pretty common during pregnancy. Certain heart murmurs and irregular rhythms emerge due to the heart working more than its standard capacity. It is important to remember that such changes are expected during pregnancy.
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Abnormal Rhythms: Apart from irregular heartbeats and murmurs, a few abnormal rhythms require further diagnosis. Examples include rapid and irregular heart rate for a long period and diastolic murmurs. Diastolic heart murmurs can be explained as the heart sounds that come just before heart contraction.
What Is the Pulse Rate During Pregnancy?
A pregnant woman's pulse rate typically increases as the body adapts to the physiological demands of pregnancy. Heart palpitations or an increased pulse rate during pregnancy can cause the heart to race or skip a beat. These non-uniform patterns can seldom be alarming but, in most cases, are not harmful. This results from the increased blood flow through the body, which is supposed to provide for the growing fetus and the placenta. A woman usually has a resting pulse heart rate of ten to 20 beats per minute, higher than the normal pre-pregnancy rate. Such elevated heart rates result from increased blood flow into the body.
Hormonal ups and downs in the course of pregnancy may additionally be one of the rational reasons for a soaring pulse rate. Remember that caffeine and other caffeine-incorporated drinks must be kept at bay at all costs in case palpitations are experienced because they add up to an immediate increase in the heart rate.
What Is the Blood Pressure During Pregnancy?
Blood pressure fluctuates throughout pregnancy due to various factors, including hormonal changes, increased blood volume, and changes in vascular resistance. A shooting rise in blood pressure during pregnancy is a familiar trait. It generally goes away after neonatal birth. In a few cases, however, this rise in blood pressure can indicate a genuine and far-reaching condition known as pre-eclampsia, wherein the increase in blood pressure leads to impairment of other vital organs. Blood pressure, or BP, measures how firmly the blood is flushed against the walls of the blood vessels. Monitoring blood pressure is crucial during pregnancy, as high blood pressure (hypertension) can pose risks to both the mother and the fetus, including pre-eclampsia (marked by elevated blood pressure and indications of impairment in another bodily system, commonly affecting organs such as the liver and kidneys) and other complications.
It is recorded in two parameters separated by a line: systolic and diastolic. For instance,120/80 mm Hg blood pressure is where the systolic pressure, or the pressure when the heart is pumping, is 120, and 80 is the diastolic pressure, or the pressure between each heartbeat. 140/90 mm Hg is considered to be high blood pressure. This condition of having a higher level of blood pressure is called hypertension.
A blood pressure drop may occur within the first twenty-four weeks of the pregnancy. Hypotension is having a lower blood pressure of 90/60 mm Hg or even less. It is not uncommon during pregnancy due to hormonal changes and also because blood is rerouted to the fetus. Fatigue, dizziness, episodes of fainting, and visual disturbances are temporary symptoms of hypotension that can be easily corrected after consulting the respective healthcare professional.
Conclusion
The heart goes through a lot of backbreaking work during pregnancy. For this reason, ensure one prepares one's heart well enough before getting pregnant. Overall, these physiological changes are normal adaptations to support the increased metabolic demands of pregnancy. However, healthcare providers need to monitor these parameters closely and timely to ensure the well-being of both the mother and the unborn child. Whenever a couple intends and plans to conceive, it should be made a routine practice to schedule an appointment with a cardiologist along with an obstetrician. By understanding the dynamic nature of the cardiovascular system during pregnancy, healthcare providers can better manage, maintain, and care for expectant mothers throughout this transformative pregnancy period.
